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Adoptive Cell Transfer: Cancer Immunotherapy Explained

Adoptive cell transfer is an immunotherapy in which immune cells are taken from a patient, modified in a laboratory, and reinfused to fight cancer more effectively.

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Things worth knowing about "Adoptive Cell Transfer"

Adoptive cell transfer is an immunotherapy in which immune cells are taken from a patient, modified in a laboratory, and reinfused to fight cancer more effectively.

What is Adoptive Cell Transfer?

Adoptive cell transfer (ACT) is an advanced form of immunotherapy used primarily in cancer medicine. In this approach, immune cells – typically T cells – are collected from the patient, genetically modified or expanded outside the body in a laboratory, and then reinfused into the patient. The goal is to enhance the patient's own immune system so that it can recognize and destroy cancer cells more effectively.

Mechanism of Action

The underlying principle of adoptive cell transfer is based on the immune system's natural ability to detect and eliminate foreign or abnormal cells. In cancer, this ability is often impaired. ACT addresses this problem through the following steps:

Collection: Immune cells (usually T cells) are harvested from the patient's blood or tumor tissue.
Modification: The cells are genetically engineered or selectively expanded in the laboratory to enhance their tumor-fighting properties.
Expansion: The modified cells are multiplied in large numbers.
Reinfusion: The cells are returned to the patient via infusion, where they specifically target and attack tumor cells.

Types of Adoptive Cell Transfer

TIL Therapy (Tumor-Infiltrating Lymphocytes)

In this approach, lymphocytes that have naturally infiltrated the tumor are extracted, massively expanded in the laboratory, and reinfused. These cells already have a natural affinity for the tumor and can attack it effectively.

CAR T Cell Therapy

CAR T cell therapy (Chimeric Antigen Receptor T Cell Therapy) involves genetically modifying T cells to express an artificial receptor on their surface that specifically binds to cancer cells. This approach has achieved significant success in certain types of leukemia and lymphoma.

TCR Therapy (T Cell Receptor Therapy)

In this method, T cells are engineered to express a specific T cell receptor (TCR) that recognizes cancer cells based on their internal proteins. This approach is also applicable to tumor types that lack surface antigens.

Areas of Application

Adoptive cell transfer is primarily used or investigated in the following conditions:

Hematological cancers: Leukemias, lymphomas, multiple myeloma
Solid tumors: Melanoma, lung, breast, and colorectal cancer (partly still in clinical trials)
Infectious diseases: Research approaches in HIV and other viral infections

Side Effects and Risks

Like all intensive therapies, adoptive cell transfer can cause significant side effects:

Cytokine Release Syndrome (CRS): An excessive immune response that may cause fever, low blood pressure, and organ damage.
Neurotoxicity: Neurological symptoms such as confusion or seizures, particularly associated with CAR T cell therapies.
Infections: Because the immune system may be weakened during therapy, there is an increased risk of infection.
On-target/off-tumor effects: Modified cells may also attack healthy tissue that shares similar markers with the tumor.

Current Developments and Future Perspectives

Adoptive cell transfer is one of the most promising areas of modern oncology. Numerous clinical trials are investigating its use in solid tumors, where the therapy has historically been more challenging to apply than in blood cancers. The development of allogeneic (donor-derived) cell products – so-called off-the-shelf therapies – could greatly simplify access to this treatment in the future and significantly reduce costs.

References

Rosenberg SA, Restifo NP. Adoptive cell transfer as personalized immunotherapy for human cancer. Science. 2015;348(6230):62-68.
June CH, et al. CAR T cell immunotherapy for human cancer. Science. 2018;359(6382):1361-1365.
National Cancer Institute (NCI). Adoptive Cell Transfer: A Type of Immunotherapy. Available at: https://www.cancer.gov. Accessed 2024.

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