Expanding CAR-T therapy to recruit first-stage clinical patients
Release date: 2014-12-04
On December 2, US biopharmaceutical company Unum Therapeutic announced the start of the recruitment of a phase of clinical patients. Its so-called universal T-cell immunotherapy drug ATTCK20 will be used in combination with Rituxan for the treatment of chronic leukemia (CLL). ATTCK is the abbreviation of Antibody-Targeted Tumor Cell Killing, which means that antibodies lead to tumor cell killing. ATTCK is a derivative strategy of CAR-T therapy. ATTCK also uses patient T-cells, but unlike most CAR-Ts that target CD19, ATTCK recognizes antibody drugs. ATTCK20 is a T-cell that recognizes Rituxan, so it needs to be used in conjunction with Rituxan. Rituxan binds to the tumor cell surface antigen CD20 and then binds to ATTCK-type T-cells to achieve the effect of killing tumor cells.
CAR-T is rapidly becoming a new platform for the treatment of cancer. The underlying technology is to train the patient's T-cells from ordinary warriors into professional killers. This technology began to develop as early as 20 years ago, but early efforts have had little result, mainly because of poor efficacy. Until the advent of CTL019 3 or 4 years ago, up to 90% of patients with relapsed/refractory polar leukemia had a complete response, and some patients responded for up to two years. CAR-T is a rare disruptive technology in the history of medicine, so many people expand the platform from different angles.
Most CAR-T therapies now target CD19, and Unum is a technology-specific drug. This idea has some similarities to ADC (antibody drug-conjugated) and BiTE (double-selective T-cell binding protein), a technique that can shed the dependence on CD19 antigen and target a wider range of antigens through antibody drugs. The company's name comes from the Latin American motto "E pluribus unum", translated into English called "out of many, one", and Chinese is translated as "common one." It means that although everyone comes from all corners of the country, there is only one revolutionary goal.
The emergence of CLT019 is like the first person to eat crabs, which is the most risky and difficult step. Although there are not many people who dare to eat crabs for the first time, once the crabs are proven to be able to eat more chefs who can invent new ways of eating in the world. Unum's broad-spectrum antigen technology is just one extension. There is also the so-called "off-the-shelf" CAR-T, which converts stem cells into T-cells directed against a certain tumor antigen without extracting T-cells from the patient. Of course, there is also a CAR-T for solid tumor antigens.
The development process of CAR-T shows the full range of requirements for technology and capital in the development of new drugs. The basic idea of ​​using T-cells to fight cancer has long been available, but it took 20 years to figure out the technical details. Juno and the world-renowned hospital Sloan Medical Center's CAR-T experiment was stopped by the FDA at the beginning of the year because two patients died. The first childhood patient, Emily Whitehead, developed a severe immune response after using CLT019 and was sent to the ICU.
If the patient is not dead in a world-class healthcare environment like Penn, then CAR-T will stagnate again. Penn's doctor quickly discovered that Emily's IL-6 level was 1000 times higher than that of the average person, and promptly used the IL-6 antibody drug Tocilizumab to make her recover quickly. The early involvement of pharmaceutical giant Novartis also strongly supported this technology in capital and technology. If China wants to join the competition for new drug research and development in the world, even if it does not support the capital and technology environment for such pioneering drug development, at least there must be basic research and capital markets for Unum-class companies. Even if someone finds that crabs can be eaten, if you only scramble eggs, then high-end dining has nothing to do with you.
Source: US and Chinese medicine source
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