Cancer immunotherapies: CAR-T cells produced in vivo

Cellular immunotherapies, these treatments with immense potential, are based on an ultra-simple principle. They consist of reprogramming certain immune cells in the patient, rearming them to destroy harmful cells, such as those involved in cancers or autoimmune diseases.
One such strategy, successfully used in blood cancers, is based on "CAR-T cells." Here, T lymphocytes, a category of white blood cells, are taken from each patient's blood. They are then delivered in vitro with a genetic instruction, which instructs them to produce a surface protein: the CAR, or chimeric antigen receptor. In short, it is an artificial receptor designed to bind to a protein (an "antigen") carried by the patient's tumor cells. For example, to the CD19 protein, present in excess on B lymphocytes in certain lymphomas or leukemias.
Once reinjected into the patient, these CAR-T cells act as homing missiles. Thanks to their famous CAR, they bind specifically to the antigen present on the tumor cells, which they eliminate. Another advantage: because they are living cells, they proliferate in the patient's body, where they operate "as long as there is still cancer to destroy," Michel Sadelain, a pioneer of this approach at the Memorial Sloan Kettering Cancer Center in New York, explained to Le Monde in 2024. To date, seven CAR-T cell therapies have been approved in the United States and Europe against certain lymphomas, myelomas, or leukemias. The strategy is also the subject of early clinical trials in solid tumors and autoimmune diseases.
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Le Monde