CAR T-cell therapies are one of the most promising and publicized immunotherapies, but limited in applicability. Two CAR T-cell immunotherapies approved by the FDA in 2017, Kymriah and Yescarta are limited to patients with specific types of blood cancer and failing prior conventional therapies. They are both designed for blocking a specific molecular target on cancer cells, either leukemia or lymphoma known as CD19. However, the CD19 molecule present on cancerous B cells is not the only one enabling them to multiply and grow. Rather, some patients with leukemia or lymphoma do not have CD19 on their cells, so the existing T-cell treatments do not work for them. Other patients, have CD19 at first and go into remission when treated, but then lose the protein and relapse within six months.

Researchers at the National Cancer Institute are engineering T cells to target the CD22 molecule (CD22-CAR) that is present on cancerous B cells, either in addition to CD19 or as the main driver of cancerous growth. This experimental therapy, if successful will provide an option to desperately ill leukemia patients who are relapsing on FDA approved CD19-CAR T-cell therapies. Additionally, it opens up the possibility of combination immunotherapy with two types of CAR T-cells administered simultaneously for enhanced results. These important developments are well covered in a New York Times Health article by author Denise Grady.

The Cancer Treatment Navigator team supports cancer patients in identifying the latest available treatment options and enabling access to targeted therapies and immunotherapies. Cancer patients often ask us about “Tumor melting T-cells”, described in press releases and news publications that highlight the breakthrough aspect, but often fail to explain the limitations of newly approved treatments. As scientific advisors to cancer patients, we explain nuances of approved immunotherapies and highlight experimental immunotherapies that might be more applicable to their specific cancer. Experimental immunotherapies require careful navigation given multiple clinical research trials running nationwide by hospitals and academic institutions. We encourage patients to leverage scientific research as part of their cancer care approach. Our team aims to emphasize balanced reviews and reports such as the New York Times article referenced above, so patients can be well educated and informed about cancer treatment choices.

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Photo: Cancer fighting T-cell attacking Leukemia cell from New York Times; Eye of Science, via Science Source

Immunotherapy for Melanoma: Photo courtesy OfficialScience20

Cancer Treatment Navigator (CTN) provides expert, personalized services for identifying cancer immunotherapy trials that are closely matched based on extensive review of your cancer’s genetic profile and your medical records. For Advanced Melanoma patients, there is an immunotherapy trial, KEYNOTE-252/ECHO-301, that is important to consider. This is a study investigating the combination of the Immunotherapy Keytruda with Epacadostat (an agent that acts as a different arm of the immune system than Keytruda, and leads to enhanced anti-tumor activity). This combination of two immunotherapy drugs, is expected to bring better results.  The study is enrolling patients at more than 120 locations. The CTN team matches cancer patients with the appropriate trial based on their medical & treatment history and works with your Oncologist as part of your personal cancer care team.

http://www.curetoday.com/articles/combination-immunotherapy-being-investigated-in-advanced-melanoma

Glioblastoma’s unfavorable prognosis is largely due to the high possibility of recurrence combined with limited approved treatments. Several clinical trials with new treatment approaches for recurrent glioblastoma are running at a variety of cancer treatment hospitals, academic and government institutions. They offer hope but create a tough landscape to navigate for patients and caregivers. Some therapies are acknowledged more in popular press while shadowing others with hidden potential.

To this end, the Cancer Treatment Navigator (CTN) team would like to highlight a novel treatment currently in clinical trials for recurrent glioblastoma. It was brought to our attention via an interview with Dr. Priya Kumthekar, MD and Dr. Alexander Stegh, Ph.D. at Northwestern University Feinberg School of Medicine, published last month in OncoTherapy Network. It is called NU-0129 and is a so-called nano-particle. That means super small. NU-0129’s super small size and shape allows it to successfully reach the site of the tumor in the brain. Once there, it interferes with the cancer cell’s biology and stops its growth which essentially can kill the cancer cells. Researchers at Northwestern University are evaluating this drug for its tolerability and ability to get directly to the brain tumor for maximum effectiveness.

On a practical level, rapid advancement in clinical science for cancer treatment has left oncologists strapped for time and resources. Especially when research is required beyond standard hospital protocols for treating most patients. When a clinical trial is considered, very often the clinical trial run by a patient’s hospital ends up being recommended as the best course of action. But that doesn’t mean it is the best choice based on comprehensive research and consideration of all trials running throughout the country. Consequently, one of our main objectives at CTN is to help cancer patients gain access to promising clinical trials based on thorough research and evaluation of published data and compared to the diagnosis, treatment history and specific cancer type of each individual client. Another hurdle that we help overcome is the unnecessarily restrictive eligibility criteria for trial enrollment. Often patients are turned away because many trials only pre-select for very healthy cancer patients to participate. This is done to minimize side effects that might be blamed on the study drug. However, cancer patients are often not healthy, but they still deserve the right to make their own decision about added potential health risks from an experimental medicine. We share the belief with many experts in the field that clinical trials should be for a patient’s welfare and not only for the benefit of a hospital or an individual company’s new blockbuster drug.