Imagine being able to treat solid cancer (those found in an organ in the form of a mass) through laparoscopy. Also imagine that through this minimally invasive surgery it is possible to place some capsules next to the tumor that will shed cells, genetically modified in the laboratory, to detect and eliminate it. Can you imagine? Well, it’s a reality.
The Jerez-born doctor participates in this great medical advance Sandra Hervás-Stubbs, researcher of Immunology and Immunotherapy Program of the Research Center of the University of Navarra, the main person in charge of the center in the project.
The CAR-T cell therapy It constitutes a new way of approaching cancer treatment that has shown efficacy in blood cancers (hematological tumors), but not in solid tumors, those that grow in organs and tissues. Is novel therapy it uses genetically modified patient lymphocytes so that they can recognize and destroy tumor cells after being injected.
CARTsol (‘Encapsulation of CART cells in bioactive nanostructured porous systems for their targeted delivery in solid tumors’) is coordinated by the University of Santiago de Compostela and, together with Cima, form this interdisciplinary consortium the Salamanca Cancer Research Center and GALARIA SA, public company of sanitary services. Part of these centers are participants in the Cancer Network Biomedical Research Center (CIBERONC) of the Carlos III Health Institute.
“At the moment there are already six approved treatments for blood tumors, but so far none have been approved for solid tumors“, declares Hervás-Stubbs. The first step in this new approach is the extraction of T lymphocytes from the cancer patient. Why are these cells so important? Well, because the T lymphocytes are part of the immune system Formed from stem cells in the bone marrow, they help protect the body from infection and fight cancer.
After extraction in the laboratory, two important things are done. “On the one hand they genetically modified. They put a new gene that expresses a new receptor, which for people to understand, is like giving them eyes that will allow them to recognize the tumor. Those eyes, that receiver, is what is known as CAR-T. Besides are expanded in the laboratory to have millions and millions of those cells. All of those expressing that new receptor and then infused into the patient. This is the same for blood cancers as for solids,” explains the doctor.
In cases of blood cancer, these cells “travel” through the blood and when they find the tumor, they destroy it. But in the case of solid tumors is more complicated, because it is not enough to move through the blood, but the CART cells have to enter the organ where the cancer is”. “Tumors have sought many systems to prevent the entry of cells that can attack them. They have a framework that does not allow T lymphocytes or CART cells to enter and they have also prepared a very hostile environment for them. With the treatment that we propose, we try to alleviate the difficulties that CART cells have”, describes Hervás-Stubbs.
What do they propose? A ‘Trojan horse’: “What we do is that instead of injecting the CART cells into the patient intravenously (as for blood cancers), what we do is we put them in inside some capsules that are prepared. Inside they have a hydrogel in which the T cells are comfortable, there are growth factors. In addition, the casing has some holes through which the CART cells can exit. These prepared capsules are implanted, by laparoscopy, very close to the tumor or even in the bed that remains when the tumors are removed by surgery.”
“These capsules are like the Trojan horse that will allow the CART cells to be released in an area very close to the tumor,” declared the Jerez-born woman. But medical advancement goes further, because these capsules are also loaded with drugs. “That is also where the key lies. These drugs are going to have several functions. There are drugs that are going to help soften the tumor tissue so that the cells can penetrate it, others are going to help change the hostile environment and others are going to help CART cells can amplify, can proliferate, increase in number. With this synergy, what we are looking for is for this treatment to be more effective in solid tumors”, the doctor underlines.
At the moment the project is in the preclinical phase and for three years the model and the prototype for breast cancer (which with slight modifications will serve in other phases of the project for other types of tumors).
More research and dissemination
“The dissemination of research news is essential. That people are aware of the difficulties there are in carrying out research and what research contributes in the treatment of diseases”, emphasizes Hervás-Stubbs.
The doctor declares that “it is not only important to obtain financing from the Government, something of course key, but also through foundations that raise money from businesses and private donors. The information is key because if our work is not reported, the need to donate to research will not be seen.”
Hervás-Stubbs also focuses on the commitment of the scientists themselves to make their work public “in a simple way so that progress can be seen. We have to get involved.” The Jerez native also stresses the need to financially support young people: “It is very important to give them financial aid, because the problem we are going to have in a few years is that there will not be a good generational change if we do not support young people now, if we do not bring in the talent that has left abroad”.
“And of course, it is necessary have lines of research and consolidate them with some serious research plans. That money is not given for free, a good plan must be demanded,” remarks Hervás-Stubbs.
