WASHINGTON, Sept 15 — When Michel Sadelain began his decades-long quest to genetically modify immune cells to fight cancer, his peers dismissed his ideas as absurd and even his mother grew concerned for his career.
He was passed up for grants, promotions became uncertain, and graduate students steered clear of joining his lab. At the time, there was great interest in developing vaccines to train the immune system to recognize and destroy cancer cells, in the same way it can be taught to tackle foreign invaders such as bacteria and viruses.
Beyond recognising the cancer, these Chimeric Antigen Receptor T-cells, as Sadelain named them, were also given genetic instructions to enter a killing mode and to multiply, growing an army inside the body to eliminate the enemy. In a trial against multiple myeloma, a cancer that develops in plasma cells, 72 per cent of patients responded to treatment, with total disappearance of the disease seen in 28 per cent, among whom 65 per cent had sustained eradication for 12 months.The treatment comes with serious side effects — including in some cases death — from the release of inflammatory molecules called cytokines. Doctors have learned to recognise and manage this better over time.
One area he acknowledges must improve is the sky high cost, with price tags upwards of US$500,000. In the United States, private and government-subsidised insurers pick up most of the tab for those who qualify, as do health systems in Europe.