CAR T-Cell therapy in solid tumors

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July 2021: CAR T-Cell therapy in solid tumors has been approved in China with certain indications and markers. Recently, CAR T-Cell therapy is been tested for solid cancers like :

  • Breast cancer
  • Non-small-cell lung cancer
  • Liver cancer
  • Cholangiocarcinoma
  • colorectal cancer
  • gastric cancer
  • Mammary cancer
  • esophageal cancer
  • pancreatic cancer
  • Oophoroma
  • Gallbladder cancer
  • Uterine cancer

CAR T-Cell on all these cancers is applicable for patients who have relapsed after some lines of treatment such as surgery, chemotherapy and radiotherapy.

It’s the first CAR T-Cell case around the world that a 5 year old girl named Emily with Leukemia was cured in 2012.

Jimmy Carter, 90, a former US president, announced that melanoma cells had spread to the liver and brain.
On December 6, 2015, with the PD-1 antibody plus radiotherapy, the cancer cells in vivo disappeared.
On March 6, 2016, he no longer needed treatment for melanoma.
On December 2, 2018, he also appeared at the funeral of former President Bush.

At the end of 2013, immunocytotherapy was rated as one of the top ten technological breakthroughs of the year by Science magazine.
In 2014, two authoritative cancer academic conferences, AACR and ASCO, were held in the United States. Immunotherapy has become the focus of cutting edge technology. In 2014, the FDA approved the listing of nivolumab and pembrolizumab.

CAR T Cell therapy in thyroid cancer

In 2015, Movie director Chen Xunqi was diagnosed with undifferentiated thyroid cancer, underwent surgery and multiple chemotherapy in Beijing, and gave up chemotherapy;
In 2016, PS score is 3 when he is in hospital, skinny, and decided to try CAR T therapy after two courses to make the tumor disappear;
In 2017, it was tested and rechecked, normal; in 2018, it was tested and rechecked, normal;

What is CAR T Cell therapy?

T cells enter tumor tissues, secrete immune checkpoint antibodies (PD-1, CTLA-4 and other antibodies), and gradually change the tumor’s local immunosuppression microenvironment.
CAR-T in T cells kill target tumors and releases cytokines to up-regulate MHC expression and expose tumor antigens. Meanwhile, immune checkpoint antibodies reduce tumor local microenvironment T cell (TIL) inhibition, and infiltrated T cells begin to Start, activate and multiply.
CAR-T & TIL produce a cluster effect, turning tumors into an immune battlefield, killing all kinds of tumor cells together and turning them into hot tumors, completely destroying tumors and forming effector memory T cells, reducing the possibility of tumor recurrence.

Side effects of CAR T-Cell therapy in solid cancer cases

Out of 25 patients who had solid cancers, 25 went for CAR T-Cell trials:

  • high fever was found in 6 patients
  • dyspnea and pneumonia symptoms in 2 patients
  • 1 patient had dry skin and dandruff
  • no other patients showed significant abnormalities.

Case A: lung cancer patient undergoing CAR T-Cell therapy

In November of 2009, the patient found a left lung mass and underwent radical left lung cancer radical surgery. Pathology: lung adenocarcinoma;
From Jan 2013 to January 2017, three brain metastases occurred, and surgery and radiation therapy were given successively with poor control;
From March 2017 to September 2017, for brain metastases, mesoCAR-αPD1 cells expressing PD-1 antibody were given six courses of treatment. After treatment, PR was evaluated and tumors shrank significantly with only a small amount of residue.

Case B: A Testicular cancer patient undergoing CAR T-cell therapy

In August of 2016, the patient found a mass in the right scrotum and underwent surgical treatment. Pathology: embryonic rhabdomyosarcoma;
In March of 2017, review of PET-CT, found that the peritoneum, omentum, and intestine were unclear, considering multiple metastases in the abdominal cavity;
From June to September 2017, mesoCAR-αPD1 cells that expressed the PD-1 antibody were given 4 times. The effect was CR; all metastases in the abdomen went away.

Case C: A Lung adenosquamous carcinoma patient receives CAR T-Cell therapy

In November 2017, the left upper lung adenosquamous carcinoma (6.4 “2.9cm) was detected, accompanied by metastasis of the left clavicle and bilateral cervical lymph nodes. He was admitted to hospital for treatment, and Ⅲ and V bone and brain depression occurred after 3 chemotherapy , Side effects are strong. Choose to try immunotherapy combined with chemotherapy.
On January 2 and February 6, 2018, two immune cell infusions were performed, and the body improved significantly, and the side effects of chemotherapy gradually subsided. Re-examination showed no re-metastasis of the tumor or increase.
Examinations at the end of February 2018 showed that the lesions in the lungs had shrunk significantly and the cancer condition was already under control.

Case D: A Liver cancer patient underwent CAR T-cell therapy

On June 1, 2017, a 66mm x 46mm tumor was detected at the upper end of the left lobe lung. On June 15th, he was admitted to the Oriental Hepatobiliary Surgery Hospital for treatment. Based on the results of CT-guided lung puncture biopsy, a three-in-one treatment plan combining CAR-T cell immunotherapy, targeting therapy + chemotherapy was developed.  On July 29, 2017, the first immune cell infusion therapy was performed. After the infusion, the body reacted strongly. After his condition was stable, his condition improved initially. After more than six months of immunotherapy combined with targeted therapy, tumors in the body have been significantly smaller.

Case E: A Lung cancer patient with brain metastasis underwent CAR T-cell therapy

On November 26, 2009, a 3.03 “2.39cm tumor was detected in the upper lobe of the left lung, and the upper left lobe was removed directly and completely at an early stage.  On January 25, 2013, numbness in the left lower extremity failed to detect a brain metastatic tumor Resection of deep lesions on the screen + targeted therapy with Iressa. 6 In June 2016, a sheet-shaped, abnormally enhanced foci appeared at the junction of the right frontal-parietal lobe for intracranial tumor resection. In 2017, brain tumor Deterioration, a tumor of about 3.3 “2.8 cm, appeared in the right parietal lobe, and multiple meningeal metastases and radiotherapy was performed. 3In March 2017, immunotherapy was started. Four times before and after the infusion, the tumor in the brain has improved significantly.

Case F: An Undifferentiated thyroid cancer patient receive CAR T-cell therapy

In 2016, he was diagnosed with undifferentiated thyroid cancer. Quine is the most malignant type of thyroid cancer, and doctors told that only 2 months of life were left. After several radiotherapy treatments, she lost 30 pounds, but her body did not improve. She subsequently refused to receive chemotherapy. Later, I went to try immunotherapy. After 2 immune cell infusions, the cancer cells in the body have completely disappeared.

Case G: A Hypopharyngeal cancer patient receives CAR T-Cell therapy

In July 2014, was diagnosed with hypopharyngeal carcinoma, linary sacral carcinoma. 2 courses of chemotherapy and hypopharyngeal cancer surgery and right neck dissection. After a year and a half, he relapsed, and then continued radiotherapy, during which side effects were obvious and his physical condition was extremely poor.  On January 13, 2016, four immune cell infusions were successively received. The condition began to stabilize and the situation improved significantly. From July to December 2016, five more cell infusions were performed, and the physical condition gradually improved, with normal sleep and appetite. In the case of paralysis in bed for several months, and the muscles gradually atrophied, his weight increased from 80 kg to 112 kg.

Case H: A Left breast cancer patient with brain metastasis receives CAR T-Cell therapy

In January 2014, she was diagnosed with diffuse breast cancer with lung and liver metastases. From January to November 2014, 9 chemotherapy sessions were performed.  From June 2015, cancer cells metastasized to the brain, and 11 cranial gamma knife treatments were performed, and the cancer cells spread completely. 3In March 2017, in Hong Kong, received PD-1 treatment and still failed. Beginning in April 2018, we tried CAR-T immunotherapy. After one course of treatment, the effect was remarkable. The swelling of the brain and liver disappeared. The swelling that had spread throughout the lungs was only scattered. Reduced to 1.2.

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