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Advancements in CAR T-cell therapy and the need for strategic collaboration

Article-Advancements in CAR T-cell therapy and the need for strategic collaboration

Image via Canva Pro CAR T-cell therapy
With CAR T-cell therapy, patients have a new and potentially life-saving treatment option to fight what can be a devastating disease.

Lymphoma, a form of blood cancer that affects the lymphatic system – the network of tissues, vessels, and organs that comprise part of the body’s immune defenses – is on the rise in Saudi Arabia. An often debilitating and sometimes fatal condition, lymphoma is characterised by lymphocytes, the body's essential white blood cells that fight infection, becoming abnormal and multiplying uncontrollably.   

Hodgkin lymphoma and non-Hodgkin lymphoma are the two primary forms of lymphoma. A 2019 study published in the Saudi Medical Journal confirmed that the incidence of non-Hodgkin lymphoma in the Kingdom has risen over the past two decades, with the disease’s increasing prevalence presenting as a pressing public health issue and making the raising of awareness of its symptoms and features an important endeavour.  

Survival rates for both Hodgkin and non-Hodgkin lymphomas depend on several factors, including the type and stage of cancer, the age and overall health of the patient, and the type of treatment administered. For Hodgkin lymphoma, the five-year relative survival rate for all patients is approximately 89 per cent1, a significant improvement compared to previous decades. Survival rates for non-Hodgkin lymphoma vary based on the subtype. According to data from 2012 to 2018, the five-year relative survival rate for diffuse large B-cell lymphoma is approximately 65 per cent, while follicular lymphoma has a 90 per cent survival rate2. 

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Fortunately, there are numerous treatment options available for patients diagnosed with lymphoma today, including chemotherapy, radiation therapy, targeted therapy, immunotherapy, and stem cell transplants. One of the latest and most promising treatments for lymphoma is cellular therapy, also known as CAR T-cell therapy. This groundbreaking form of immunotherapy involves engineering a person's immune cells to target and destroy cancer cells. With CAR T-cell therapy, patients have a new and potentially life-saving treatment option to fight what can be a devastating disease. 

CAR T-cell therapy is a groundbreaking approach that uses genetically modified T-cells taken from the patient's own immune system. In the laboratory, these T-cells are engineered to produce chimeric antigen receptors (CARs) that can identify and attack specific cancer cells. After their modification, the T-cells are infused back into the patient's bloodstream, where they seek out and destroy cancer cells. This therapy has shown promise in treating relapsed or refractory lymphomas – types of lymphoma that have not responded to other treatments. 

The success of CAR T-cell therapy in treating lymphoma patients depends on several factors, such as the type and stage of the lymphoma and the individual's underlying health. Clinical trials have shown promising results in treating aggressive lymphomas, with response rates ranging from 50 per cent to 80 per cent3. Studies show that patients who respond to this therapy tend to experience long-term remissions, with some remaining disease-free for several years4. The significant response rates and long-term remissions seen in the clinical trials suggest that cell therapy has the potential to revolutionise the treatment of lymphoma.  

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With advancing technology and ongoing research, CAR T-cell therapy will likely become an integral part of standard treatment regimens for blood cancers. However, like any new treatment, CAR T-cell therapy carries potential risks and side effects, such as neurological toxicity, cytokine release syndrome (when the body reacts aggressively to the therapy), and prolonged cytopenias (lower than normal blood cell counts). 

Along with a group of distinguished international, regional, and national experts, I attended the 4th International Lymphoma Conference held in Jeddah, Saudi Arabia on May 19 and 20 this year. The conference focused on key topics related to Hodgkin lymphoma, aggressive lymphoma, indolent non-Hodgkin lymphoma, T-cell lymphomas, therapy, and the challenges faced by lymphoma patients, such as access to high-quality care. 

Lymphoma patients face several challenges, including limited healthcare resources and infrastructure, especially in areas with a shortage of skilled healthcare professionals. A major issue for many is the restricted access to advanced therapeutics, such as stem cell transplants and cellular therapy, while the high cost of treatment is also a significant obstacle, especially for patients who lack adequate health insurance or financial resources. In addition to these physical and financial hurdles, lymphoma patients may also experience psychological and emotional challenges, such as anxiety, depression and uncertainty about their prognosis and treatment outcomes. These difficulties can be particularly challenging for patients facing relapse or a more advanced stage of the disease, making access to comprehensive supportive care and counseling essential for patients and their families. 

Strategic collaborations are among the solutions that have the potential to significantly improve patient outcomes and address the unmet needs of lymphoma patients. Partnerships between healthcare professionals, governments, the private sector, and patient associations are essential for advancing research, developing new treatments, and providing support services for patients and their families. Such collaborations can facilitate greater access to healthcare resources, innovative therapies, and financial assistance programmes, which can help to alleviate the burden of treatment costs for patients. Additionally, partnerships can facilitate the sharing of knowledge and best practices, which in turn lead to improved patient care and outcomes. Overall, strategic collaboration is an essential step toward improving the lives of lymphoma patients and reducing the impact of this form of cancer. 

It is also crucial to realise the importance of raising awareness to ensure that lymphoma patients have access to high-quality and timely healthcare. Various forms of awareness campaigns targeting different audiences, including patients, families, caregivers, healthcare professionals, and the public, can significantly improve patient outcomes. It is essential to educate patients about the symptoms, available treatment options, and the possible side effects of the various therapies, as well as for the public to emphasise the importance of screenings for early detection. Prompt diagnosis leads to more treatment options and better chances for successful outcomes.   

Support groups can play a crucial role in improving the health of lymphoma patients. Patient support groups can provide emotional care, practical advice, a sense of community, information, education, and advocacy opportunities for people living with lymphoma. They offer a safe space for patients to share their feelings, fears, and concerns with others who are going through a similar experience. These groups provide practical advice on how to manage treatment side effects, cope with the disease, and navigate the healthcare system. By bringing patients together and providing a community, patient support groups can significantly improve the quality of life for lymphoma patients and their families. 

I cannot overemphasise the significance of addressing the unmet needs of lymphoma patients, particularly in terms of prompt, accessible, and equitable access to care. Progress in research and technology, such as cellular therapy, provides hopeful treatment options. Strategic collaboration among various stakeholders – including healthcare professionals, governments, patient associations, and the private sector – is essential to prioritise patient-centred care, provide education and support services, and tackle systemic obstacles to care. Furthermore, increasing awareness of lymphoma and the significance of early detection, whenever feasible, can save lives and make a significant difference in the quality of life for individuals and their families affected by this challenging disease. 

 

Dr. Mubarak Al Mansour

Dr. Mubarak Al Mansour is the Chairman, Princess Noorah Oncology Center, Ministry of National Guard Health Affairs, King Abdulaziz Medical City and Associate Professor, Medical Oncology at the College of Medicine, King Saud bin Abdulaziz University for Health Sciences.   

 

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