Adoptive cell therapy

Adoptive Cell Therapy

Adoptive cell therapy (ACT) is a form of immunotherapy that involves the infusion of immune cells into a patient to help fight diseases, particularly cancer. This approach leverages the body's own immune system to target and destroy cancer cells. ACT has shown promise in treating various types of cancer, including melanoma, leukemia, and lymphoma.

Mechanism of Action

ACT works by enhancing the natural ability of the immune system to combat cancer. The process typically involves the following steps:

1. Isolation of Immune Cells: Immune cells, often T cells, are collected from the patient or a donor. These cells are crucial for identifying and attacking cancer cells.

2. Modification and Expansion: The isolated T cells are genetically modified or selected for their ability to recognize cancer cells. They are then expanded in large numbers in the laboratory.

3. Infusion into the Patient: The modified and expanded T cells are infused back into the patient. These cells can then seek out and destroy cancer cells.

4. Monitoring and Support: After infusion, patients are monitored for response to therapy and potential side effects.

Types of Adoptive Cell Therapy

There are several types of ACT, each with unique characteristics and applications:

• Tumor-Infiltrating Lymphocytes (TILs): This approach involves isolating T cells that have naturally infiltrated a tumor, expanding them in the lab, and reinfusing them into the patient.

• Chimeric Antigen Receptor (CAR) T-Cell Therapy: T cells are genetically engineered to express receptors that specifically target cancer cells. CAR T-cell therapy has been particularly effective in treating certain blood cancers.

• T-Cell Receptor (TCR) Therapy: T cells are modified to express specific T-cell receptors that can recognize cancer antigens presented by tumor cells.

Clinical Applications

ACT has been used to treat various cancers, with notable success in:

• Melanoma: TIL therapy has shown significant efficacy in treating metastatic melanoma.
• Leukemia and Lymphoma: CAR T-cell therapy has been approved for certain types of leukemia and lymphoma, demonstrating high response rates.
• Solid Tumors: Research is ongoing to improve the effectiveness of ACT in treating solid tumors, which present unique challenges compared to blood cancers.

Challenges and Future Directions

While ACT has shown great promise, several challenges remain:

• Toxicity: Some patients experience severe side effects, such as cytokine release syndrome and neurotoxicity, particularly with CAR T-cell therapy.
• Tumor Microenvironment: The immunosuppressive environment of solid tumors can hinder the effectiveness of ACT.
• Antigen Escape: Cancer cells may evolve to evade detection by the modified T cells.

Future research is focused on improving the safety and efficacy of ACT, developing new targets, and expanding its use to a broader range of cancers.

Also see

• Immunotherapy
• CAR T-cell therapy
• Cancer treatment
• Tumor microenvironment

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