ForPatients and Families

Cancers are usually characterized by rapid cell growth. The earliest cancer drugs were derived from agents used in chemical warfare. These drugs, now known as chemotherapy, were designed to kill all fast-growing cells. Unfortunately, many normal cells in the body grow fast, so chemotherapy drugs are often non-specific and lead to undesired side effects, such as gastrointestinal toxicity, hematological toxicity and other problems, such as hair loss. In some cases, toxicity from conventional chemotherapy drugs can cause serious harm or even be fatal.

Thanks to major advances in the understanding of the molecular biology of cancers, specific cellular features have been discovered that are associated with certain cancers. These discoveries have allowed for the development of targeted cancer therapies. Targeted cancer therapies generally have fewer side effects compared to older chemotherapies.

We take this tactic even further by using engineered immune cells (NKT cells) to target specific cancer molecules. This approach may bring several advantages:

1. The engineered NKT cells have a specific targeting molecule, termed a chimeric antigen receptor or CAR, which helps the cells find and kill cancer cells.
2. The engineered NKT cells have a prolonged life and can replicate in the patient, providing long term protection against newly developing cancer cells, leading to longer responses and potentially preventing relapses.
3. In addition to the CAR, the engineered NKT cells have natural tumor fighting ability thanks to the invariant T cell receptor present on these cells, which recognizes and directly kills some tumors and also kills inhibitory cells within the tumor, leading to immune activation against the tumor.
4. The engineered NKT cells can home to sites of solid tumors, which have historically been difficult to treat with other immune cellular therapies.

Lymphoma is a cancer of lymphocytes, which are cells that are part of the immune system. There are many types of lymphoma. One type is Hodgkin lymphoma. The rest are called non-Hodgkin lymphomas (NHLs). NHLs begin when a type of white blood cell called a T lymphocyte or a B lymphocyte, becomes abnormal. The cell divides again and again, making more and more abnormal cells. These abnormal cells can spread to almost any other part of the body.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of NHL worldwide, accounting for up to one-third of patients with newly diagnosed NHL. DLBCL is an aggressive (fast-growing) NHL that affects B-lymphocytes. B-lymphocytes (or B cells) are a type of white blood cell that make antibodies to fight infections and which are an important part of the immune system. Although it can occur in childhood, the occurrence of DLBCL generally increases with age, and most patients are over the age of 60 at diagnosis. DLBCL can develop in the lymph nodes or in “extranodal sites” (areas outside the lymph nodes) such as the gastrointestinal tract, testes, thyroid, skin, breast, bone, brain, or essentially any organ of the body. It may be localized (in one spot) or generalized (spread throughout the body). Despite being an aggressive lymphoma, DLBCL is considered potentially curable, although many patients will respond to initial therapy and then experience a relapse at a later date.

Hepatocellular carcinoma (HCC) is a cancer that starts in the liver. Many cancers spread (metastasize) to the liver, but HCC is different because it begins in the liver. There are risk factors that increase the chances of a person developing HCC. Most people have an underlying liver disorder including infection with hepatitis viruses, scarring of the liver (cirrhosis), a condition in which fat builds up in the liver (non-alcoholic fatty liver disease), and a condition in which fat builds up in the liver along with inflammation and liver cell damage (nonalcoholic steatohepatitis or NASH). Heavy drinking is also a risk factor for HCC. Unfortunately, the outlook for people with HCC is poor. Before HCC spreads from its original site, the 5-year survival rate is about 30%, but once there is spread to nearby tissues the survival rate drops to about 10%.

If HCC is found early enough and the underlying liver condition has not compromised liver function, a patient may be eligible for surgical removal (resection) of the tumor. Additionally, some people with small tumors may be candidates for a liver transplant. If surgery or a transplant is not possible, affected individuals may undergo radiofrequency or microwave cancer treatments. Transarterial chemoembolization (TACE) may also be used to treat HCC. TACE works by blocking the blood supply to the cancer. Once the blood supply is blocked (embolized), chemotherapy is given right into the cancer. Some people who have cancer that has spread outside of the liver have benefited with treatment with a drug called sorafenib. Some physicians may recommend that a person with HCC join a clinical trial, especially if their disease seems resistant to standard treatment options.