In July 2017, the FDA recommended a new type of cancer treatment with strong ties to glycobiology. The treatment uses the body’s own immune system to fight cancer. It is called immunotherapy. If approved, which seems highly probably, the therapy would treat only one particular disease, a blood cancer called acute lymphoblastic leukemia (ALL). However, further research is expected to extend it to a variety of cancers.
CAR T-Cell Therapy
Researchers at the University of Pennsylvania and pharmaceutical giant Novartis joined forces in 2015. They launched a study called ELIANA to investigate the use of a treatment Novartis calls CTL019 in children with a difficult-to-treat leukemia. The overall treatment approach is known as CAR T-cell therapy. It involves removing some T-cells from the patient’s blood. T-cells are a type of defensive white blood cell within human immune systems. Researchers add a glycoprotein antenna to the outside of each cell in a laboratory. The cells are genetically engineered to express CARs created to bind with a particular glycoprotein (antigen) on the patient’s tumor cells. The GE receptor is called CAR (chimeric antigen receptor). Chimeric means it is made up of lots of different parts and pieces genetically engineered into a single, new glycoprotein receptor. When the artificially engineered, altered T-cells are transfused back into the body, these receptors help the T-cells find the particular glycoprotein on the cancer cells. Then, the T-cell can kill it.
Altered Glycosylation–A Universal Feature of Cancer
Altered glycosylation is a feature of cancer cells. This means they have some unique glycoproteins/cell antennas on their surface. T-cell with genetically engineered receptors targeted for those glycoproteins can zero in on those cells. Preliminary results are very encouraging. The study involved 50 children with ALL and researchers reported 82 percent of the children achieved complete remission after three months. Overall survival was 89 percent after six months and 79 percent after 12 months. This is dramatic improvement over what is offered in traditional radiation, surgery, and chemotherapy (standard of care) today. The researchers plan to follow each patient for 15 years and will release information on 5-year survival rates when it becomes available.
Cytokine Release Syndrome
One of the problems facing doctors has to do with handling the immune response that comes with the treatment. When people catch the flu or bacterial infection, the fevers, aches, and pains associated with the flu are not from the virus or invading bacteria. They come from our immune system waking up to fight the invaders. This also happens when a patient receives engineered T-cells. Extremely high fevers and inflammation increases because of the immune system chemicals generated to wage the war. This can be dangerous if the response exceeds thresholds for what the body can endure but it is evidence the immune system is working. Eight out of 10 patients developed what was called cytokine release syndrome—a total-body inflammatory response. Many of these patients required treatment in the intensive care unit (ICU) but they all survived. Adverse reactions also included infections, hallucinations and low blood cell counts.
Genetic Engineering Concerns
Another safety concern occurs when healthy cells express the same glycoprotein as the cancer cells. A T-cell attack on healthy cells could be life threatening. Extreme care and careful toxicity and longevity testing are needed to ensure the glycoproteins are unique only to the targeted cancer cells. These T-cells are genetically engineered (GE) and so the problems associated with GMOs applies here. The long-term problems of having GE T-cells traversing throughout the body for the rest of one’s life would have to be assessed. A common method for engineering CAR T-cells for cancer immunotherapy involves the use of viruses. Viral vectors such as retrovirus, lentivirus or transposon are used to integrate the transgene into the T-cell’s own genome. Viruses are capable of rewriting the DNA in a cell with their own DNA through reverse transcription and they kidnap the manufacturing plants within the cell to make more viruses. This ability of viruses is a serious risk which could compromise the T-cell’s own genes and lead to more cancer.
So, while this new cancer treatment shows great promise and works because of glycobiology, the risk associated with using GE gives cause for great concern. Hopefully, in their excitement about the amazing results of this cancer treatment, they won’t shortcut the long-term genetic engineering toxicity testing necessary to alleviate these serious problems related to GMO. Of course, you won’t hear about the natural plant-based options for supplementing these sugar nutrients which build these glycoprotein receptors and have no adverse affects or toxicity. That will always be the work of our Not-For-Profit, the GRM.
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