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Novel immunotherapy options for cancer coming of age

Cell therapy has a long track record in medicine dating back to the transfusion of whole blood to wounded soldiers during the Second World War. A couple of decades of cell culture and animal research were required before the medical community felt ready for hematopoietic stem cell transplantation – the next key step in cell therapy. In the late 60’s, this opened a whole new field of therapeutic options for patients with inborn defects of immunity, diseases of hematopoiesis or hematological malignancies. (Read more)

Thereafter and during the past four decades, hematopoietic stem cell transplantation has established its role in the treatment of a multitude of diseases of the bone marrow or bone marrow-derived cells with more than 500 000 transplantations performed in the industrialized countries, and more than 40 000 annually in Europe, both for pediatric and adult patients.

Yet, these steps have been taken by using unmodified or only mildly manipulated cells either from the bone marrow or peripheral blood, and relapses have remained a key concern for those with aggressive, hematological malignancies.

Development in cell manipulation techniques during the past ten years has provided us with all new tools to tackle these problems. T-cells with chimeric antigen receptors (CAR-T) have emerged as a viable, novel option particularly for patients with aggressive, hematological malignancies, who have either relapsed after an allogeneic stem cell transplantation or have been resistant to conventional primary therapy modalities. The basic idea is to genetically engineer patient’s own defender T-cells so that they can attack the malignant cells when transfused back to the patient. The first of these products (tisagenlecleucel) has just recently been approved by the FDA for clinical use as a 2nd line therapy among patients with lymphoid malignancies, and several others are in the pipeline.

This technology will open a whole new era of targeted cellular therapy, not only in the treatment of hematological malignancies, but also in that of many solid tumors (e.g. neuroblastoma, sarcomas etc.) and perhaps certain forms of hemophilia A.

To establish a role for the Academic Medical Center Helsinki and the Helsinki University Hospital in this rapidly evolving field, the University of Helsinki announced an opening for a full professorship in Cell Therapy and Transfusion Medicine through a donation by the Finnish Red Cross Blood Service. The undersigned was appointed to this post from September the 1st. In addition to the development in clinical cell therapy outlined above, a wealth of novel research questions have emerged with this development and will be tackled through several PhD thesis projects to be launched during 2018, under the auspices of the Pediatric Research Center and in close collaboration with the research department of the Finnish Red Cross Blood Service and the key research groups in the Academic Medical Center Helsinki.