The Clínic, in relation to CAR-T in Europe, has made cancer disappear in half of the cases.
The hospital consolidates the use of this therapy and already has new clinical trials underway.
BarcelonaIn 2017, professionals at the Hospital Clínic performed the first infusion of a CAR-T treatment (from the Englishchimeric antigen receptor-T), a cell therapy that has already revolutionized the approach to some types of cancer. It consists of creating a drug with the patient's own cells: the white blood cells (T lymphocytes) are extracted, genetically reprogrammed in the laboratory to recognize tumor cells, and then reinfused to neutralize the cancer. Since then, the hospital has treated more than 500 patients with this type of immune therapy and has managed to eliminate the cancer in half of these cases. In this way, it has become a benchmark in Europe, being the only one to have developed two exclusively academic therapies that are already approved in Spain:Ari-0001, for severe patients with acute lymphoblastic leukemia, and theAri-0002h, for patients with multiple myeloma.
Eight years later, the hospital is leading a decentralized model for the administration of CAR-T cells throughout the country, in collaboration with 13 Spanish hospitals with the aim of making these therapies available to the entire territory. "It is a unique model in the world; there is no other place with a program similar to ours," claimed Álvaro Urbano-Ispizua, coordinator of the CAR-T program at Clínic-IDIBAPS during the press conference on Wednesday. The doctor explained that they have treated 186 leukemia patients, 191 myeloma patients, and 125 lymphoma patients, and in half of the cases, complete remission of the cancer has been achieved, that is, the absence of disease.
In the remaining cases where there has been a relapse, Urbano-Ispizua has pointed to several causes. Sometimes the reprogrammed cells are unable to identify all the tumor cells, so he has announced that they are developing a new CAR-T that recognizes several threats at once. In other cases, the patient's own immune system rejects the modified cells because it doesn't recognize them, making therapy impossible. The final cause the expert has pointed to is that the CAR-T can lose functionality; the infused cells become "exhausted" and stop attacking the tumor.
However, the development of these immunotherapies has revolutionized the fight against cancer, and new CAR-T cells are expected to emerge in the future to combat other diseases. CAR-T therapies have so far only been approved in 34 countries, and approximately 38,000 patients have been treated worldwide. This means that only 4% of the total number of patients who could benefit from treatment have access to them. Therefore, Clínic professionals insist on improving accessibility and argue that decentralized CAR-T production makes it possible to bring treatment closer to patients.
New therapies
Hospital Clínic is already underway with a new clinical trial for a novel CAR-T cell, ARI-0003, which is designed to combat lymphoma and has a unique feature that experts are confident will cure patients with an "enormous number of malignant cells," Urbano-Ispizua emphasized. This is a dual CAR-T cell, meaning it targets two therapeutic targets present in tumor cells. This way, the treatment would recognize several threats at once. In addition, the center will soon begin a trial with the HER2 CAR-T cell for the treatment of breast cancer and with the ARI-007 CAR-T cell for the treatment of people diagnosed with acute lymphoblastic T-cell leukemia.
The center is treating an increasing number of patients each year, reaching more than 100 annually. Furthermore, the Clínic continues to develop new CAR-T cells in the laboratory "with improvements to significantly increase their efficacy," according to a statement. However, it hopes to continue growing after this "important milestone" and reach 500 patients treated, stated the general director, Josep Maria Campistol, who noted that the development of CAR-T cells has been initially driven by the ARI Project and supported by the la Caixa Foundation and the Carlos III Health Institute (ISCIII).
