CD19-targeted CAR T cells Therapy

Abstract

Over the years, the scientific community has been studying and exploring different strategies to treat cancer using gene therapy techniques that have culminated in the development of an immunotherapy called Chimeric Antigen Receptor (CAR) T cells therapy. Recently, two different types of CAR T cell therapies have been approved to treat B cell malignancies by the FDA and the AEMPS: tisagenlecleucel (Kymriah®) and axicabtagene ciloleucel (Yescarta®), becoming an important paradigm shift due to their special characteristics. These medicines are autologous biological medicines where immune cells, concretely T lymphocytes, are collected from the blood of the patient, processed and sent to manufacturing facilities. There, gene-editing modification is performed through viral vectors in order to express certain chimeric antigen receptors in the cell membrane of the T lymphocytes. Here comes the key to the success of these revolutionary therapies: these artificial receptors are able to get linked and recognize specific antigen, CD19, that is expressed in the entire B-cell lineage. Once they recognize it, T-cell expansion, cytotoxic activity, releasing of cytokines and proinflammatory substances happen and, therefore, anti-tumour effects are achieved. In addition, an analysis of the situation in our country related to these therapies will be performed: the Banc de Sang i Teixits (BST) plays an important role in the manufacturing process since they collect leukapheresis material, process it and cryopreserve it before it is shipped to manufacturing facilities and the other way around. Finally, current challenges of these therapies such as side effects and logistic aspects will be discussed. Furthermore, the possible future perspectives of these immunotherapies will be exposed.