Manipulating T Cells to Treat Patients With Cancer

Bruce Feinberg, DO, explains how chimeric antigen receptor T cells were introduced in hematologic malignancies.

Bruce Feinberg, DO, vice president and chief medical officer at Cardinal Health Specialty Solutions, explains how the exploration of chimeric antigen receptor (CAR) T cells began.

In the 1980s, many researchers were still focused on finding treatment that could stop cancer that invades the body. But, with more understanding that cancer occurs from human cells that transform, the focus shifted to finding treatments that could address the failure of the host. According to Feinberg, this was the beginning of immunotherapy.

Then in the mid-2000s, after success had been demonstrated with immune checkpoint inhibitors, T-cell manipulation was discovered, says Feinberg.


0:07 | The story of CAR T goes back a little before the drugs were approved. The recognition that our view of cancer in general was thinking of cancer as an invader. The way we thought about bacteria or viruses so that they were the enemy that we are going to then destroy. The recognition that changed all that was rather than thinking about cancer as the external alien enemy, because cancer was created by cells, and they are human cells that are transforming, should we be thinking about how to then look at the problem a little bit differently and see it as a failure of the host, as opposed to the invader. The story really begins as we think about empowering the immune system. The first aspects of that go back to the 1980s with interferons, interleukins, and tumor-infiltrating lymphocytes, and that was the first round.

1:13 | The second way begins as we started to now think about the mid-2000 teams with the immune checkpoint inhibitors and start to look at manipulating T cells. The T-cell manipulation that begins with CAR T is not stopping with CAR T. It is going to be developing into bispecific antibodies, and natural killer cells that are then manipulated, so we are going to be seeing a rapid expansion of this host empowerment, how we really trigger the immune system to do its job, and then control this process, which really is a process of self as opposed to the external enemy.