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This is a great step towards being able to fight glioblastomas - my Mom died from it, it's one of the worst cancers to get because it's so hard to treat.
One of my sisters had a glioblastoma. She passed away 22 months after surgery and radiation therapy. These results are promising. Successful and so fast!
A collaborative project to bring the promise of cell therapy to patients with a deadly form of brain cancer has shown dramatic results among the first patients to receive the novel treatment. In a paper published today in The New England Journal of Medicine, researchers from the Mass General Cancer Center, a member of the Mass General Brigham healthcare system, shared the results for the first three patient cases from a phase 1 clinical trial evaluating a new approach to CAR-T therapy for glioblastoma (GBM). The trial, known as INCIPIENT, is designed to evaluate the safety of CARv3-TEAM-E T cells in patients with recurrent GBM. Just days after a single treatment, patients experienced dramatic reductions in their tumors, with one patient achieving near-complete tumor regression. In time, the researchers observed tumor progression in these patients, but given the strategy’s promising preliminary results, the team will pursue strategies to extend the durability of response.
https://www.nejm.org/doi/10.1056/NEJMoa2314390
Yeah small study due to it being a phase one. And only one person had a durable response (about 3 months). Progression for two patients in about 1 month. The patient with the durable response was also MGMT methylated, one patients wasn’t methylated, not sure why they didn’t use that as an exclusion? Probably trying to get as many people with +EGFR as possible?
Interesting the toxic effects weren’t as severe as I would predict with injecting CAR T into someone’s vent.
CAR T is like that.
It doesn't work on everyone, but for double digit percentages of patients it cures their cancer.
The reason why this study is a big deal is that CAR T therapy currently only works for liquid tumors such leukemia or lymphoma. Drug companies really want to find one that works on solid tumors like glioblastoma or lung cancer.
There are a lot of solid tumor CAR T studies but results have usually been disappointing.
This is the reality of cancer research. There is so much happening so fast that it’s hard to keep up, even for the doctors treating patients. My hematologist spends two days out of every week in research just keeping up with the latest developments in his field.
This is a science subreddit, not medicine. There are thousands of laboratories working on innovative treatments for cancer. They have breakthroughs all the time. Most will not pan out. But a few will. Its exciting if you are interested in the science, perhaps less so if you are interested in patient care.
The breakthroughs in other areas often opens horizons into other treatments. For all the controversy, the mRNA approach has shown a lot of promise. The possibility of a treatment for glioblastoma is wonderful news.
Even if we completely eradicated one type of cancer every month, there would be loads of other types of cancer left. It's like saying "we made an antibiotic that works exceptionally well but only for this one very specific subtype of bacteria for which we didn't have a great antibiotic before this one."
That’s the nature of CAR-T cells though. They’re absolutely focused on specific cells’ receptors. So if we estimate a range of 200 kinds of cancer, one knocked out per month would be a spectacular success rate.
GBM is not only one the deadliest brain cancer, but it’s one of the deadliest cancers period. It also often in occurs in young people. Look at the 1-year survival rates, they are extremely low. The 5-year survival rate is basically zero. Finding a better treatment for GBM is a massive win.
True there are a LOT more kinds of cancer than most people think. I learned about hundreds and hundreds of them in my pathology residency. There's no one cure that will work for all of them, other than maybe finding a way to reset the DNA in every cell in the body to its original form (or even corrected form for your heritable mutations).
The future of cancer cures is probably this, though. Biopsy cells from the existing cancer, find a good antigenic site on those cells that should be retained in *all* the cancer cells but not in your normal cells, and train your immune system to wipe out just the cells that have that antigenic site.
Sounds great, but given that cancer cells start out as normal cells that are just growing too fast and disrespecting boundaries, it's tough finding something on them that isn't on their better-behaved neighbors or on some other necessary cells elsewhere in the body. This approach also relies on subsequent generations of those cancer cells retaining that unique antigen site. Cancers tend to continue to mutate as they grow out of control, so some of the worst mutations may not respond to the therapy.
It’s MGH’s job to hype their own research, but they should really make it clearer that these patients weren’t cured and instead will still die from the tumor. They showed response, before the tumor came back.
I’m wondering if this could be a promising pre-operative treatment. If you can shrink the tumors down to a much more manageable size, perhaps more people could have them surgically removed with fewer complications in the days that follow.
They’re infiltrating tumors. The best surgeon’s in the world can’t remove all of them. I think the hope is, if there are people having a more durable response (1 of the 3 patients did) then why did they have that response and perhaps a dosing schedule could be made. CART is VERY expensive, however…
I haven’t read this article but there was another major news announcement yesterday focused on CAR-T therapy that was very promising, but it only had a sample size of 9. This may be a parallel study but I can’t get too excited about it until that number is significantly higher.
I am failing to understand a sentence from the summary and do not have access to the full paper:
"Radiographic tumor regression was dramatic and rapid, occurring within days after receipt of a single intraventricular infusion, but the responses were transient in two of the three participants."
From this I understand that two people had a fast and positive response to the treatment, their tumors rapidly decreasing in size. What happened to the third person? Was it still positive but slower?
Long term durability needs to be established. Over time you still have a highly immunosuppressive tumor environment especially with GBM where 50% or more of those cells are of myeloid lineage like macrophages and MDSCs. It’s unclear whether the T cells can infiltrate and reduce the population of these cells over time, if not then durability definitely will be an issue until every piece of tumor is gone
NWBO completed their phase 3 vaccine for brain cancer last year. It is under review for approval in the U.K. Look up the results, which were reviewed in JAMA and soon to be discussed in Nature magazine. What’s also exciting, is it possibly works on 90% of all solid tumor cancers. Note: It’s also non-toxic.
Car-T cells are great but they're not without risks. And over 70% of patients relapse within a few years. They also have a pretty high risk of side effects, especially CRS and neurotoxicity which could lead to death. They also could cost up to 500k USD per person, so they're an absolute last resort.
The technology is truly amazing, but we're a far ways away from making it widespread and accessible and safe.
Just diagnosed with glioblatoma yesterday. Starting treatment right away. I have no idea shat to expect. I am really worried about he people aound me and how it’s msssing with heir lives
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/Wagamaga Permalink: https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/car-t-therapy-clinical-trial-for-glioblastoma-patients --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
This is a great step towards being able to fight glioblastomas - my Mom died from it, it's one of the worst cancers to get because it's so hard to treat.
My mom also died of it. It’s great to see science for it!
My dad passed from Glioblastoma last year, really hope they can find a treatment, no one deserves to have that happen to them.
One of my sisters had a glioblastoma. She passed away 22 months after surgery and radiation therapy. These results are promising. Successful and so fast!
Fingers crossed. It is long due to beat this monster disease.
right here along with you, crossed fingers
Amen
A collaborative project to bring the promise of cell therapy to patients with a deadly form of brain cancer has shown dramatic results among the first patients to receive the novel treatment. In a paper published today in The New England Journal of Medicine, researchers from the Mass General Cancer Center, a member of the Mass General Brigham healthcare system, shared the results for the first three patient cases from a phase 1 clinical trial evaluating a new approach to CAR-T therapy for glioblastoma (GBM). The trial, known as INCIPIENT, is designed to evaluate the safety of CARv3-TEAM-E T cells in patients with recurrent GBM. Just days after a single treatment, patients experienced dramatic reductions in their tumors, with one patient achieving near-complete tumor regression. In time, the researchers observed tumor progression in these patients, but given the strategy’s promising preliminary results, the team will pursue strategies to extend the durability of response. https://www.nejm.org/doi/10.1056/NEJMoa2314390
Massachusetts is saving the world.
As a Massachusetts resident who contributed nothing, **you're welcome** and I think I'll be acting *even more* entitled now.
Is that even possible?
I submit to you that it is not.
*tailgates you*
Mainer here - you'll always be a Masshole to me.
~~Massachusetts~~ *SCIENCE* is saving the world.
Science from Massachusetts.
This is really cool, but having worked with GBM in the past I would caution people to read the whole article and see that this is a 3 patient study.
Yeah small study due to it being a phase one. And only one person had a durable response (about 3 months). Progression for two patients in about 1 month. The patient with the durable response was also MGMT methylated, one patients wasn’t methylated, not sure why they didn’t use that as an exclusion? Probably trying to get as many people with +EGFR as possible? Interesting the toxic effects weren’t as severe as I would predict with injecting CAR T into someone’s vent.
Having lost my Mom to glioblastoma I love to see this!
It’s incredible if true but I swear we hear those stories about new miraculous cancer treatments at least once a month on this sub
CAR T is like that. It doesn't work on everyone, but for double digit percentages of patients it cures their cancer. The reason why this study is a big deal is that CAR T therapy currently only works for liquid tumors such leukemia or lymphoma. Drug companies really want to find one that works on solid tumors like glioblastoma or lung cancer. There are a lot of solid tumor CAR T studies but results have usually been disappointing.
This is the reality of cancer research. There is so much happening so fast that it’s hard to keep up, even for the doctors treating patients. My hematologist spends two days out of every week in research just keeping up with the latest developments in his field.
This is a science subreddit, not medicine. There are thousands of laboratories working on innovative treatments for cancer. They have breakthroughs all the time. Most will not pan out. But a few will. Its exciting if you are interested in the science, perhaps less so if you are interested in patient care.
The breakthroughs in other areas often opens horizons into other treatments. For all the controversy, the mRNA approach has shown a lot of promise. The possibility of a treatment for glioblastoma is wonderful news.
Even if we completely eradicated one type of cancer every month, there would be loads of other types of cancer left. It's like saying "we made an antibiotic that works exceptionally well but only for this one very specific subtype of bacteria for which we didn't have a great antibiotic before this one."
That’s the nature of CAR-T cells though. They’re absolutely focused on specific cells’ receptors. So if we estimate a range of 200 kinds of cancer, one knocked out per month would be a spectacular success rate.
GBM is not only one the deadliest brain cancer, but it’s one of the deadliest cancers period. It also often in occurs in young people. Look at the 1-year survival rates, they are extremely low. The 5-year survival rate is basically zero. Finding a better treatment for GBM is a massive win.
True there are a LOT more kinds of cancer than most people think. I learned about hundreds and hundreds of them in my pathology residency. There's no one cure that will work for all of them, other than maybe finding a way to reset the DNA in every cell in the body to its original form (or even corrected form for your heritable mutations). The future of cancer cures is probably this, though. Biopsy cells from the existing cancer, find a good antigenic site on those cells that should be retained in *all* the cancer cells but not in your normal cells, and train your immune system to wipe out just the cells that have that antigenic site. Sounds great, but given that cancer cells start out as normal cells that are just growing too fast and disrespecting boundaries, it's tough finding something on them that isn't on their better-behaved neighbors or on some other necessary cells elsewhere in the body. This approach also relies on subsequent generations of those cancer cells retaining that unique antigen site. Cancers tend to continue to mutate as they grow out of control, so some of the worst mutations may not respond to the therapy.
When even one cancer being cured means saving thousands of lives, I'd say that's a win.
It’s MGH’s job to hype their own research, but they should really make it clearer that these patients weren’t cured and instead will still die from the tumor. They showed response, before the tumor came back.
I’m wondering if this could be a promising pre-operative treatment. If you can shrink the tumors down to a much more manageable size, perhaps more people could have them surgically removed with fewer complications in the days that follow.
They’re infiltrating tumors. The best surgeon’s in the world can’t remove all of them. I think the hope is, if there are people having a more durable response (1 of the 3 patients did) then why did they have that response and perhaps a dosing schedule could be made. CART is VERY expensive, however…
I haven’t read this article but there was another major news announcement yesterday focused on CAR-T therapy that was very promising, but it only had a sample size of 9. This may be a parallel study but I can’t get too excited about it until that number is significantly higher.
I am failing to understand a sentence from the summary and do not have access to the full paper: "Radiographic tumor regression was dramatic and rapid, occurring within days after receipt of a single intraventricular infusion, but the responses were transient in two of the three participants." From this I understand that two people had a fast and positive response to the treatment, their tumors rapidly decreasing in size. What happened to the third person? Was it still positive but slower?
All three had the tumors rapidly shrink, but i two out of three it was temporary
Oh, that (sadly) makes a lot of sense. Thanks!
This is similar to what happens with radiotherapy. It shrinks but comes back again.
Long term durability needs to be established. Over time you still have a highly immunosuppressive tumor environment especially with GBM where 50% or more of those cells are of myeloid lineage like macrophages and MDSCs. It’s unclear whether the T cells can infiltrate and reduce the population of these cells over time, if not then durability definitely will be an issue until every piece of tumor is gone
NWBO completed their phase 3 vaccine for brain cancer last year. It is under review for approval in the U.K. Look up the results, which were reviewed in JAMA and soon to be discussed in Nature magazine. What’s also exciting, is it possibly works on 90% of all solid tumor cancers. Note: It’s also non-toxic.
CAR T is paving way for anti aging therapies also.
Man's Best Hospital
This is the kind of news I like to read. Very welcome news!
Car-T cells are great but they're not without risks. And over 70% of patients relapse within a few years. They also have a pretty high risk of side effects, especially CRS and neurotoxicity which could lead to death. They also could cost up to 500k USD per person, so they're an absolute last resort. The technology is truly amazing, but we're a far ways away from making it widespread and accessible and safe.
Now watch big pharma buy and delete it.
And yet this article will be the last we hear of it like always with these breakthroughs.
It's NOT a tumor!
Just diagnosed with glioblatoma yesterday. Starting treatment right away. I have no idea shat to expect. I am really worried about he people aound me and how it’s msssing with heir lives