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  • Ilayda Arslan

A BREAKTHROUGH THAT HAS BEGUN WITH EMILY

Hello again, it is me Ilayda. Recently, I have taken a course related with car-T cell immunotherapy. As someone who will have been reading these sentences, I felt so stranger to this word "car-T cell". Lots of thoughts have suddenly migrated to inside of my mind and i decided to dive in cool therapeutic subject.


Indeed, I am writing this text just as a review of the course i have taken. I know that it should have been done earlier. Whatever, i just want to compansate my procrastination. And finally, I want to send my all virtual hugs to every person who will have been glancing this text.

Therefore, Let's get started to dive in inspiring topic ! I am planning to keep up my text within Qs and As format.


+What is the "car-T cell" and What is the point of this procedure?


T cells are one of the major cellular components of the immune system, helping the body to fight off disease. It was not until 1976 that the primary T cell growth factor, interleukin-2 (IL-2), was discovered, making ex vivo culture of T cells possible. In melanoma (skin cancer) it was shown that T cells could be extracted from resected tumors, restimulated with IL-2 ex vivo, and administered autologously back to the tumor site to kill the melanoma cells.


T cell receptors can also be modified to confer the T cell with additional cancer-targeting properties. T cells have been genetically modified to express engineered receptors called chimeric antigen receptors (CARs), and these modified cells are known as CAR-T cells. These chimeric receptors allow CAR-T cells to detect cancer cells that would normally go undetected by the body’s natural T cells. Experiments with this CAR-T for cancer were performed by Zelig Eshhar, part-time beekeeper and full-time scientist in 1989; Carl June experimented with CAR-T for HIV in 1992. Clinical responses from these modified cells were not initially encouraging, as the T cells would quickly become exhausted in vivo and lose function.


The next generations of CAR-T included additional stimulatory molecules in the CAR, potentiating the antitumor effect. Antitumor responses from these CAR-Ts were much stronger, especially for blood cancers. It took over a decade to perform the first clinical trials for these CAR-T cells for cancer. During this trial, pediatric cancer patient Emily Whitehead would become the face of CAR-T cancer therapy. Emily was five years old and at death’s door when she started treatment with CAR-T. Her reaction to the therapy was immediate and dramatic. It was so strong that she was placed in a medically induced coma to protect her. However, the treatment ultimately proved successful and she has now been cancer-free for over seven years. After the dramatic success that Emily and other patients had, the first CAR-T therapies were approved in 2017.



Very briefly, clinically available versions of CAR-T are currently generated by removing immune cells from the patient and separating out the T cells. The T cells are then genetically engineered to express a tumor-targeting CAR, expanded, and introduced back to the patient.





image was taken from MIT lab documents


+ What clinical trial was this procedure applied to?

Firstly, This procedure was applied to treat acute lymphoblastic leukemia (ALL). Clinical trial of car-T cells was experienced at Children's Hospital of Philadelphia in 2012. Yes, you can be aware of this procedure has been recently applied. But its development process was taken dog's year. Exactly, it is keeping up this property. Yeah! We can say that science is just like that :)



+Well, Can you mention about Acute Lymphoblastic Leukemia ?


Acute lymphoblastic leukaemia is a type of cancer that affects white blood cells. It progresses quickly and aggressively and requires immediate treatment. Both adults and children can be affected.


Acute lymphoblastic leukaemia is rare, with around 790 people diagnosed with the condition each year in the UK. Most cases of acute lymphoblastic leukaemia develop in children, teenagers and young adults.


Although it is rare, acute lymphoblastic leukaemia is the most common type of leukaemia that affects children. About 85% of the cases that affect children happen in those younger than 15 (mostly between the ages of 0 and 5). It affects slightly more boys than girls.


+ You have just written "Emily" on headline of text. Let's talk about that girl blessed with good luck which is totally coming from real science :).


Emily Whitehead is first patient girl who has taken car-T cell therapy to survive against ALL cancer. Emily's story has been being evaluated as one of the immunotherapy success story. Clinical trial worked properly and she has got cancer free.

Let's read the just below text which was taken from cancerresearch.org


"Emily Whitehead and the Future of Immunotherapy"


Emily Whitehead’s story made national headlines and helped focus public attention on the potential for cancer immunotherapy to transform cancer treatment as well as the need to support lifesaving cancer immunotherapy research.


Dr. Carl June, who spent over 20 years developing Emily’s treatment with colleagues, is conducting clinical trials to test cell therapy in more types of cancer. The Cancer Research Institute is proud to support this research. In 2014, the Whitehead family has started a foundation to support pediatric cancer research.


Emily held her father’s hand as he spoke at the FDA approval hearing for CAR T cell therapy. It was approved in August 2017.


As of September 2020, over eight years since her treatment, Emily Whitehead remains cancer-free.


Learn more about Emily Whitehead's story and how the Cancer Research Institute is helping to advance research that is leading to treatments like the one Emily received. You can make a difference in the lives of patients like Emily by supporting cancer immunotherapy research efforts today.

Emily Whitehead's photos

Emily with her father


And finally i wanna say stay with science especially ethical science..!


REFERENCES

•MIT lab documents

•cancerresearch.org

•wikipedia

•UpToDate




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