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What we are doing today with CAR-T cell therapy against cancer seems like SciFi

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Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#11

Post by panabee »

puzzlingcaptcha wrote: post #8
derefr wrote: post #6

Earlier quoted context omitted.

> The real sci-fi moment will be when they get to the point they can treat in a day. How do you imagine that would work? Some closed-pipeline machine that lives in the hospital and automates sample → modified sample culture cycle? Or something stranger, e.g. some kind of injectable (maybe prokaryotic?) cells that actively swim around looking for L-lymphocytes to vectorize through bacterial horizontal gene transfer —…

> Some closed-pipeline machine that lives in the hospital and automates sample → modified sample culture cycle? That's already a thing, for example Lonza's Cocoon platform or Miltenyi's Prodigy (both are often used for on-site manufacturing).

would you mind sharing what you think are the largest bottlenecks to (1) 24-hr turnaround and (2) CAR-T therapy for < $10K?

Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#13

Post by puzzlingcaptcha »

panabee wrote: post #11
puzzlingcaptcha wrote: post #8

Earlier quoted context omitted.

> Some closed-pipeline machine that lives in the hospital and automates sample → modified sample culture cycle? That's already a thing, for example Lonza's Cocoon platform or Miltenyi's Prodigy (both are often used for on-site manufacturing).

would you mind sharing what you think are the largest bottlenecks to (1) 24-hr turnaround and (2) CAR-T therapy for < $10K?

I think that's near impossible to achieve with an autologous product. To meet those two goals I think you'd need to have an allogenic product manufactured and QCd in advance in a large batch, which you could thaw and infuse on demand. The problem with that approach is histocompatibility (HLA) matching, but several companies are working on that.

Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#14

Post by chromatin »

orochimaaru wrote: post #9
procarch2019 wrote: post #2

I work in the OT/automation space for pharma. Cell and gene therapy is crazy amazing. One thing I didn’t really see mentioned here is length of treatment. They have to collect patients sample at hospital or other facility, transport to production facility, grow sample, inject sample with vector, grow some more and then reintroduce. The real sci-fi moment will be when they get to the point they can treat in a day. I t…

Considering leukemia treatment today is 2 years for girls and 3 years foe boys, 3weeks is several magnitudes worth of improvement.

You're quoting the length of Course V Maintenance in the CALGB 10403 study (or similar pediatric COG studies on which that was based), which is misleading in that it is (a) applicable only to ALL (b) patients under 40 y (c) only the final of five courses of treatment.

That being said, you're directionally correct and certainly, shorter duration immunotherapies represent a sea change.

Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#15

Post by snitty »

I just want to emphasize that, currently, CAR-T therapies are not particularly effective for solid tumors, which make up the majority of cancer diagnoses. They're currently only good for leukemias and lymphomas. They're also not the first line of treatment, because they have to be genetically engineered from your own cells, and then reinjected into you.

There's been some progress in CAR-NK therapies, which would be "off the shelf" in that they don't need to be engineered from your own cells. Also some very preliminary work with allogeneic CAR-T therapies that wouldn't have to be made special for each person.

Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#17

Post by procarch2019 »

puzzlingcaptcha wrote: post #4
procarch2019 wrote: post #2

I work in the OT/automation space for pharma. Cell and gene therapy is crazy amazing. One thing I didn’t really see mentioned here is length of treatment. They have to collect patients sample at hospital or other facility, transport to production facility, grow sample, inject sample with vector, grow some more and then reintroduce. The real sci-fi moment will be when they get to the point they can treat in a day. I t…

The 'vein-to-vein' time (apheresis to infusion) is being shortened all the time, and you can already manufacture CAR-T cells in 24-48hrs, but it still takes about a week to clear quality assurance and release the product (microbiology, integrated copy number, integration site testing, autonomous growth potential etc). The reason being mostly that you don't want to accidentally replace patient's B cell cancer with a T…

Hah, you don’t have to tell me about validation and quality. Yes, they usually account for a significant time of anything in the pharma world.

Re: What we are doing today with CAR-T cell therapy against cancer seems like SciFi

#18

Post by robviren »

Currently a PM at the NMDP OneForum event talking to all the people driving this research. It is incredible being in a room of researchers, doctors, and providers of these types of therapy. I'll say a lot of the ordering systems could use the graceful touch of some of the HNers here, but I am in awe of what this group is capable of. Mad respect to all the people involved.
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