Immunotherapy to take on cancer, specifically through chimeric antigen receptor T (CAR-T) cells, was celebrated as a real breakthrough against the disease. So high was the optimism from the successes of lab-studies that there are now over a 100 CAR-T clinical trials being conducted worldwide. With one of the pharma companies at the forefront of such trials reporting fatal effects that are correlated to the therapy, the excitement has given way to caution. Juno Therapeutics reported that five of the 68 patients that had received the therapy as part of its clinical trial died during the study—three died because of cerebral oedema, while two others died of similar neurotoxicities. And Juno is not alone; there were some deaths associated with CAR-T therapy reported by the Memorial Sloan Kettering Cancer Centre.
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It isn’t yet clear if CAR-T cells caused any of these deaths, but the US Food and Drug Administration has announced a pilot database to evaluate CAR-T therapy’s safety. There are also side-effects like cytokine release syndrome (CRS), particularly severe in patients with a high-tumour load and B-cell aplasia (an immunological condition). Clearly, with such results, the celebration of the therapy as a wonder cancer-cure was a bit premature. But, all hope is not lost—new methods have been developed to regulate and better target the action of CAR-T cells and initial results suggest that therapeutic outcomes are significantly less damaging. Years of research led to the development of CAR-T therapy. The next phase might be just about advances in CAR-T design, with better clinical outcomes.