The Oncological Institute of Italian Switzerland (Iosi) started an international clinical trial in August 2019 for patients with aggressive lymphoma who do not respond to conventional chemotherapy treatment.
Lymphomas belong to the class of malignant tumours of the immune system, originating from lymphocytes that lose control of their proliferation and normal physiological growth. In the absence of treatment, their growth and negative course are very rapid; however, this type of tumour is curable: worldwide, thanks to chemotherapy about 60% of lymphoma patients can be cured in the first instance. Among those who do not respond to treatment or suffer a relapse, the success rate varies between 10% and 50% after an autologous stem cell transplant (obtained from the patient himself).
The clinical study of Iosi focuses on the use of stem cells in the treatment of lymphomas, particularly type B lymphomas. T-line lymphocytes, i.e. the blood cells responsible for the immune defence against infections and tumours, are isolated from the patient’s blood. T lymphocytes undergo a genetic engineering procedure, which makes them more resistant and able to recognise tumours more precisely.
Once modified, CAR-Ts (Chimeric Antigens Receptor Cells-T, engineered lymphocytes) are equipped with a targeted recognition system – the chimeric receptor – for cancer cells. They are then reintroduced into the patient’s body, previously treated with chemotherapy, where they multiply and attack the tumour, destroying it permanently.
This is a personalised procedure, as the cells of each individual patient are treated. Moreover, it is an approach that «leverages the natural anti-tumour defences already present in the patient and combines cutting-edge technologies such as gene therapy and immunotherapy,» say Iosi scholars. The Institute has already successfully treated – for the first time in Ticino – a patient undergoing treatment for aggressive B lymphoma that did not respond to conventional treatment.
This innovative technique is now being tested and the clinical trial has already recruited patients worldwide to determine whether CAR-T stem cell therapy could become a new standard of treatment for lymphoma patients. Researchers also state, «Iosi, as part of a collaboration between oncology and haematology services, has initiated a federal certification procedure, which is necessary for the use of CAR-T cell therapy in daily practice».
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