Cellular Therapies Open A Path Of Hope In The Most Aggressive Breast Cancer | The USA Print – THE USA PRINT


Two revolutionaries cell therapies -effective so far in hematological cancers– they make their way now to treat solid tumors. Specifically, this innovative treatment offers hope in the fight against breast cancer, the tumor most common worldwide and one of the main causes of mortality in the women. He Hospital Clinic of Barcelona is developing a CAR-T cell therapy for women with HER2 positive metastatic cancer and a second TIL cell therapy for women with triple negative metastatic breast cancer. Both investigations are possible thanks to the financing of El Corte Inglés (the company has invested two million euros) and the beneficiaries will be women without further treatment options.

The Hospital Clínic begins the manufacturing of two immunotherapies that until now had been shown to be effective against hematological cancers

The CAR-T and TIL cell therapies are “treatments” personalized which consist of the administration of cells of the immune system”, Explain Laura Angelats, researcher in the Translational Genomics and Therapies aimed at solid tumors Group at the Clínic. He immune system It is the key to cancer and that is why more and more treatments are aimed at its cells. “If the immune system did not fail, there would be no cancer,” he points out. Aleix Prat, director of the Institute of Cancer and Blood Diseases of the Hospital Clínic-Idibaps.

The triple negative and HER2 positive breast tumors, in addition to being very aggressive, are very minority: each one represents only the 15% of the total of breast cancer cases. The majority is the hormonal, which represents 70% of the cases and has an index of 80% survival. However, there is a group of women with breast cancer for which there is still no way out. “Our goal is, in 2030, to reach 70% survival in all cancers [actualmente está en un 58% en hombres y un 62% en mujeres]”says the vice president of the Spanish Association Against Cancer (AECC), Laureano Molins. Although it is El Corte Inglés that finances these investigations, the AECC decides which projects award this investment.

CAR-T against HER2 positive

The Clínic is a leader in the development of CAR-T therapies. These types of treatments consist of performing a genetic modification of the patient’s blood: doctors they draw blood (specifically, the T cells of the immune system), the genetically modify and they transfuse it again. Very crudely stated: the patient becomes his or her own donor. This treatment has so far proven effective in hematologic cancers as the lymphoblastic leukemia acute and the B cell lymphoma. Now the Clínic has started the phase 1 of the study to create a CAR-T aimed at a solid tumor: that of HER2 positive breast cancer.

This Barcelona hospital is a leader in the development of CAR-T therapies, which consist of the genetic modification of the patient’s blood

This study, in which the Hospital 12 de Octubre in Madrid and the University Clinic of Navarra (CUN), will take place mainly at the Clínic, according to the hematologist of this hospital, Julio Delgado. The objective is to evaluate your toxicity and lay the foundations for later development of one new therapeutic option for women with HER2 positive breast cancer. “This CAR-T [cuyo nombre será ARI-HER2] It is capable of being activated with a high expression of the HER2 protein. This would be the first step to create a pioneering therapy”, says Angelats. Furthermore, it could be effective for other cancers, since HER2 protein is also expressed in the sarcomas.

Cellular therapies open a path of hope in the most aggressive breast cancer | The USA Print

TIL against triple negative

But, in addition to the CAR-T, the Clínic is also developing a TIL therapy, targeting the PD-1 protein, for triple negative metastatic patients. The primary objective of this study is “check safety and tolerability” of the product. The Clínic is developing this therapy together with hospitals Vall d’Hebron, 12 de Octubre and the Navarra University Clinic. Unlike the CAR-T (in Spain there are three approved, in addition to others in development) at the moment there is none in the world no approved TIL therapy.

“TILs consist of the lymphocyte activation so that they expand in number and act against the tumor. The lymphocytes are immune cells that they fight against bacteria, but sometimes They do not recognize tumors. This therapy manages to activate them,” he explains. Sonia Guedan, researcher at the August Pi i Sunyer Biomedical Research Institute (Idibaps) of the Clínic. The Barcelona hospital, which has a lot of experience in CAR-T, had never developed a TIL, a therapy that has been shown to be very effective in the melanoma (a type of skin cancer).

A challenge for the system

The development of cell therapies in the academic world lowers the price of these products, which usually are “very expensive”, as doctors recognize. According to the head of the Clínic Hematology Service, Manel Juan, a CAR-T carried out by a hospital costs the State a third of the price that can be achieved when buying it from a pharmaceutical company. Hence the importance of enhance research within the public system.

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The CAR-T of the Clinic against acute lymphoblastic leukemia in children and young adults aged 25 years has been approved, since the end of 2018, by the Spanish Agency for Medicines and Health Products (Aemps) and financed by the Ministry of Health. This means that any sick person anywhere in Spain, you can receive this treatment, much less toxic than chemotherapy, For example. Health also finances two other CAR-Ts, but from pharmaceutical companies: one like the Clínic, also against Acute lymphoblastic leukemia, and another against the most frequent forms of B cell lymphoma.

In addition, the Clínic is also developing a CAR-T against multiple myeloma, a cancer of plasma cells, which are found in the bone marrow and are an important component of immune system. Is he first CAR-T developed in Europe for this disease. Although rare, multiple myeloma is he second most common hematological cancer, behind lymphoma: in Spain it affects more than 16,000 people and every year they are detected 3,000 new cases. This therapy, which has not yet been approved, has been shown to be effective in 70% of patients it’s been a year and a half of the treatment. Additionally, the hospital also plans to develop a CAR-T against glioma, a very rare type of pediatric brain tumor.


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