Adoptive cell transfer

Adoptive Cell Transfer

Adoptive cell transfer (ACT) is an advanced form of immunotherapy that involves the infusion of immune cells into a patient to help fight diseases, particularly cancer. This technique harnesses the body's own immune system to target and destroy cancer cells, offering a personalized approach to cancer treatment.

Overview

Adoptive cell transfer is based on the principle of enhancing the natural ability of the immune system to combat cancer. The process typically involves the extraction of immune cells from the patient, their modification or expansion in the laboratory, and their reinfusion into the patient.

Types of Adoptive Cell Transfer

There are several types of adoptive cell transfer, each utilizing different types of immune cells:

Tumor-Infiltrating Lymphocytes (TILs)

Tumor-infiltrating lymphocytes are immune cells that have naturally infiltrated a tumor. In TIL therapy, these cells are extracted from a patient's tumor, expanded in large numbers in the laboratory, and then reinfused into the patient. This approach has shown promise in treating melanoma and other cancers.

Chimeric Antigen Receptor (CAR) T-Cell Therapy

CAR T-cell therapy involves genetically engineering a patient's T cells to express chimeric antigen receptors that specifically target cancer cells. This method has been particularly effective in treating certain types of blood cancers, such as acute lymphoblastic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL).

T-Cell Receptor (TCR) Therapy

TCR therapy involves modifying T cells to express specific T-cell receptors that recognize cancer antigens. This approach allows the immune system to target cancer cells more precisely.

Procedure

The adoptive cell transfer process generally involves several key steps:

1. Collection of Immune Cells: Immune cells are collected from the patient, often through a process called leukapheresis.
2. Modification and Expansion: The collected cells are either genetically modified or expanded in the laboratory to increase their numbers and enhance their cancer-fighting abilities.
3. Conditioning Regimen: Before reinfusion, patients may undergo a conditioning regimen, such as chemotherapy, to deplete existing immune cells and create a more favorable environment for the infused cells.
4. Infusion of Modified Cells: The modified immune cells are infused back into the patient, where they can seek out and destroy cancer cells.

Applications

Adoptive cell transfer has been primarily used in the treatment of various cancers, including:

• Melanoma
• Leukemia
• Lymphoma
• Breast cancer

Challenges and Future Directions

While adoptive cell transfer has shown significant promise, there are challenges that need to be addressed, such as:

• Toxicity: Some patients experience severe side effects, including cytokine release syndrome.
• Tumor Escape: Cancer cells may evolve to evade detection by the immune system.
• Manufacturing Complexity: The process of modifying and expanding immune cells is complex and costly.

Research is ongoing to improve the efficacy and safety of adoptive cell transfer, including the development of "off-the-shelf" cell therapies and combination therapies.

Also see

• Immunotherapy
• Cancer treatment
• Gene therapy
• Monoclonal antibodies

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