'Living drug' offers hope to terminal blood cancer patients

Yup. Turns out, the organs in the body have a purpose, and without them the body can't work :-)

I.e. zombies are magical creatures, even less plausible than godzilla.

I also curmudgeonly think that Game of Thrones lost its appeal when it stopped being about political intrigue and became yet another silly magical zombie movie.

It's a living drug because it's a drug which is in some sense alive. It's made up of T-cells, from the patient's body, but modified.

We also distinguish "live vaccine" from "inactivated" or "killed" vaccines, for example OPV the cheapest way to prevent polio is a live vaccine, it's a version of the Polio virus that has adapted to a slow life in a cold medium, and then you eat it (literally, it was traditionally given by adding one drop to a sugar cube, the patient eats the sugar cube, delicious) and your gut goes "What? This is alien - kill it" and you become immune to Polio before it spins back up and causes any harm.

Live vaccines are dangerous (which is why we don't use OPV in countries with no polio and plenty of money, even though it is more effective than any alternative) and no doubt this drug is also dangerous, but hey, it's for people with a terminal disease so what's the worst that could happen?

Relevant xkcd: https://xkcd.com/938/

Not mentioned here: the same results can in many cases be had from BiTEs at lower cost and without having to ship leukapheresis samples to the US in liquid nitrogen

Having seen both ALL and AML patients relapsing through CAR-T, I don’t think people appreciate either the systemic load or the possibility of treatment failure that exists in real patient populations. Neither was elderly; 26yo female ALL and 5yo female AML. Both dead, both crushing disappointments after the initial excitement.

(For CAR-T therapy, the common remark is “you know it’s working when the patient goes to the ICU” from tumor lysis; but in both cases the patient’s disease outran their engineered T cells)

It's not really fair to compare BiTEs to first gen CAR. Bispecific (or tri/quad specific) CAR have a greatly reduced rate of relapse due to antigen loss (likely what is causing most relapse in these diseases).

Re: BiTEs, it's not clear they'll produce durable cures like CAR does. They're just antibodies, and will eventually be cleared. With CAR, if you can get a response, you can generate memory T-cells and control any relapse far down the road.