CAR T-Cell Immunotherapy in Human and Veterinary Oncology: Changing the Odds Against Hematological Malignancies
Résumé
The advent of the genome editing era brings forth the promise of adoptive cell transfer using
engineered chimeric antigen receptor (CAR) T-cells for targeted cancer therapy. CAR T-cell
immunotherapy is probably one of the most encouraging developments for the treatment of
hematological malignancies. In 2017, two CAR T-cell therapies were approved by the U. S Food and
Drug Administration; one for the treatment of pediatric Acute Lymphoblastic Leukemia (ALL), the other
for adult patients with advanced lymphomas. However, despite significant progress in the area, CAR
T-cell therapy is still in its early days and faces significant challenges, including the complexity and
costs associated with the technology. B-cell lymphoma is the most common hematopoietic cancer in
dogs, with an incidence approaching 0.1% and a total of 20-100 cases per 100,000 individuals. It is a
widely accepted naturally occurring model for human non-Hodgkin’s lymphoma. Current treatment is
with combination chemotherapy protocols, which prolong life for less than a year in canines and are
associated with severe dose-limiting side effects, such as gastrointestinal and bone marrow toxicity.
To date, one canine study generated CAR T-cells by transfection of mRNA for CAR domain
expression. While this was shown to provide a transient anti-tumor activity, results were modest,
indicating that stable, genomic integration of CAR modules is required in order to achieve lasting
therapeutic benefit. This Commentary summarizes the current state of knowledge on CAR T-cell
immunotherapy in human medicine and its potential applications in animal health, while discussing
the potential of the canine model as a translational system for immuno-oncology research.
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