Treating Cancer with CAR-T Cell Therapy

Transcript

• 00:04CAR T cell therapy
• 00:06is a treatment using your
• 00:08own T cells
• 00:10that have been modified
• 00:11outside your body and put
• 00:13back into you to attack
• 00:14cancer. In order to make
• 00:16any sense of that, I
• 00:17have to talk a little
• 00:17bit about what the immune
• 00:18system is. So
• 00:20the immune system is this
• 00:22large organ
• 00:23in your body made up
• 00:24of a huge number of
• 00:25cells
• 00:26that is used to detect
• 00:27foreign agents.
• 00:29T cells are a subset
• 00:31of our lymphocytes,
• 00:33and lymphocytes are important immune
• 00:35cells. They play an important
• 00:37role in, defending us from
• 00:39viral infections
• 00:40and helping other parts of
• 00:42the immune system to fight
• 00:43infection.
• 00:44One of the things that
• 00:45t cells do is to
• 00:47literally recognize
• 00:49when one of our own
• 00:51cells is infected by something,
• 00:53by what are called receptors
• 00:54on the surface of those
• 00:55t cells, and then attack
• 00:56those cells and actually destroy
• 00:58them.
• 00:59Our cancer cells aren't always
• 01:01that much different from our
• 01:02normal cells.
• 01:04Our immune system is just
• 01:06not recognizing
• 01:07these cancer cells as far
• 01:08enough
• 01:09to attack them.
• 01:11But we often know that
• 01:13cancer cells
• 01:14make certain
• 01:16proteins,
• 01:17which are little molecules,
• 01:19that are on their surfaces.
• 01:21So we can take t
• 01:22cells out of the body
• 01:23and we can engineer them
• 01:25to recognize
• 01:26the specific molecules on a
• 01:27particular cancer.
• 01:29And once a t cell
• 01:30recognizes something,
• 01:32it can destroy it.
• 01:37So how do we do
• 01:37it? As I said, we
• 01:39take the t cells out
• 01:40en masse. We do it
• 01:41by something called phoresis.
• 01:43A process that's
• 01:44a little bit more complicated
• 01:46than a a general blood
• 01:47donation, but outpatient procedure where
• 01:49the lymphocytes are filtered from
• 01:51a bloodstream for a few
• 01:52hours.
• 01:53Those cells are sent to
• 01:54a laboratory
• 01:56where
• 01:57We put a piece of
• 01:58DNA into that cell, and
• 01:59that DNA is a blueprint.
• 02:01It encodes
• 02:02what's called a receptor or
• 02:04a protein, and it's made
• 02:05up of two
• 02:06distinct
• 02:07parts.
• 02:08It's got one part that
• 02:10sticks out of the t
• 02:10cell that recognizes
• 02:12the molecule on the cancer
• 02:14and it's connected
• 02:15to a part that sticks
• 02:17into the cell that signals
• 02:19to the T cell to
• 02:20tell it to kill.
• 02:21And we call it a
• 02:22CAR because that stands for
• 02:24chimeric
• 02:25antigen
• 02:26receptor.
• 02:27And then they're expanded in
• 02:29a laboratory, so we have
• 02:30a lot of these cells
• 02:31that we can infuse to
• 02:32a patient.
• 02:34These CAR T cells, when
• 02:35they work well, will not
• 02:37only go into the body,
• 02:39but they will divide there
• 02:40and they will stick
• 02:41around. And we've
• 02:43seen that many of these
• 02:44patients have actually been cured.
• 02:46It takes many, many providers
• 02:49and professionals,
• 02:50both clinically and in the
• 02:52laboratory,
• 02:52in our cell processing lab,
• 02:54in our epheresis unit to
• 02:57collaboratively
• 02:58orchestrate
• 02:59the treatment,
• 03:00that's this complicated.
• 03:02It's a pretty big undertaking
• 03:04and,
• 03:05it requires a program, not
• 03:06just
• 03:07a physician,
• 03:09to administer these treatments.
• 03:18The FDA approvals for these
• 03:19cells are for
• 03:21diseases really of the blood
• 03:23system, so hematologic
• 03:25neoplasms.
• 03:26There is a lot of
• 03:27research trying to harness the
• 03:29same technology
• 03:30to fight solid tumors.
• 03:33Solid tumors
• 03:34in general are more advanced
• 03:36than blood tumors,
• 03:38So they're much more mutant.
• 03:40They're much more heterogeneous.
• 03:42And so Yale has a
• 03:44number of scientists who are
• 03:45working on finding the right
• 03:47target in a cancer cell.
• 03:49The targets are proteins usually
• 03:51on the surface of those
• 03:52cancer cells.
• 03:53However,
• 03:54the cancer cells can often
• 03:55lose those targets, making them
• 03:58not susceptible.
• 03:59So
• 04:00people are looking for targets
• 04:02that it's very hard for
• 04:03the cancer cell to lose.
• 04:05We have a very active
• 04:07clinical trial portfolio
• 04:09for solid tumors,
• 04:11for a lot of different
• 04:12kinds of cancers and different
• 04:14types of CAR T cells
• 04:15or other T cell redirection
• 04:18type
• 04:18therapies.
• 04:20It's a whole range of
• 04:21research from
• 04:22developing
• 04:23in a laboratory
• 04:25what is going to work
• 04:26and then eventually putting it
• 04:27into people. And that whole
• 04:29range of research is super
• 04:30important if we're gonna get
• 04:32more therapies like this
• 04:33that could really change the
• 04:35face of how we treat
• 04:36cancer.