by CAR-T immunotherapies are, today, the most revolutionary in the world of cancer. Explained very superficially, they consist of draw blood (specifically the T cells immune system) to the patient, genetically modify it And transfuse it again. So far they have shown their efficiency treat the Acute Lymphoblastic Leukemia, he B-cell lymphoma and the multiple myeloma; that’s to say, hematological cancers. But now, a pioneering study leading Hebron Valley goes further and indicates its future use to treat lupus in patients for whom conventional treatment does not work. In Catalonia There are approximately 10,000 people with lupus, a disease with a prevalence of between 50 and 120 cases per 100,000 population, with a 90% prevalence among women.
Lupus is a chronic autoimmune disease caused by the attack by the immune system itself and which can damage any organ from the body. Most patients suffer fatigue And weightloss, but other manifestations often appear such as joint pain, rash, hematologic complications either kidney damage. Vall d’Hebron has just joined the first patient in a survey, promoted by Novartis and in which four countries are participating, which will test the security and the efficiency CAR-T immunotherapy to treat this disease.
The idea of this study is open-label CAR-T therapies for lupus then to other autoimmune diseases. B lymphocytes are very important cells in lupus. In fact, we use some lymphoma treatments for our patients,” points to this log very courteous, internist and rheumatologist specializing in lupus from Vall d’Hebron. Cortés notes that although the study is “very early”, promising CAR-T therapies could be a alternative for autoimmune diseases, including “lupus is queen”.
The doctor also points out that around the 30% of patients do not respond to traditional medicines against lupus (including corticosteroids, which cause a “irreversible damage” And immunosuppressants, which are also used in transplant patients) who could benefit from this therapy if it is successful.
Nail pilot test conducted on five patients with lupus Germany showed positive results with CAR-T therapy at the end of 2022. “In the clinical trial we are starting now, we want to verify that, eliminate CD19 B lymphocytes thanks to CAR-T, the symptoms improve and the antibodies responsible for the disease even disappear,” explains Cortés.
What are CAR-T therapies?
CAR-T therapy is a innovative treatment which, until now, has been developed to treat certain types of tumors or hematological diseases, such as lymphomas, leukemias or myelomas. It consists of extracting cells from the patient’s immune system, in this case the T cells, which are genetically engineered to express a chimeric antigen receptor (CAR) and then reinfused into the patient. In the case of tumors, this change allows the modified cells to attack other cells. tumor cells.
“In the lupus, CAR-T therapy kills B cells patients, who are the responsible for the production of antibodies that cause lupus”, explains for his part Peter Beard, Director of the CAR-T Program of the Vall d’Hebron Hematology Service and Principal Investigator of the Experimental Hematology Group of the Vall d’Hebron Institute of Oncology (VHIO). Specifically, as Barba points out, CAR-T therapy “directs” T cells against B cells.
“At remove B cells from the body What are the responsible from the clinic of lupus patients, they won’t have flare-ups,” Barba points out. “This therapy revives the immune system so that attack the cells that interest us”said Monique Linares, medical specialist in hematology at Banc de Sang i Teixits (BST).
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The trial led by Vall d’Hebron, of stages 1 and 2, will take place internationally 12 patients aged 18-65 with severe lupus and which do not respond to the usual treatments. in each of them immune cells will be suppressed and targeted CAR-Ts will be created and infused again. Thereafter they will be followed for two years. Centers of Spain, France, Germany and Australia. In Spain, Vall d’Hebron and the Gregorio Marañón University General Hospital in Madrid.
Vall d’Hebron is the center that registers more CAR-T immunotherapy activity in Spain, with nearly 300 patients treated since 2019, including refractory patients with B and T lymphomas and acute lymphoblastic leukemia.
