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August 23, 2018

Using the body to recognize and attack cancer

By Susan Buckles

This article originally appeared in the Center for Individualized Medicine blog on July 23, 2018

For as long as he can remember, Saad Kenderian, M.B., Ch.B., wanted to be a physician. Nothing could blunt his resolve –not even when improvised explosive devices, bombs and trappings of war put the medical school in his native Baghdad, Iraq, on a brief hiatus. It is with that same determination he leads Mayo Clinic’s research into chimeric antigen receptor (CAR) T-cell therapy, which unleashes the immune system to attack cancer.

Saad Kenderian, M.B., Ch.B.

“With CAR T, we are on the verge of discovering the potential of immune cells. The results that we are seeing are truly unprecedented, especially in B-cell leukemias and lymphomas. Some patients who really have no other hope are going into complete remission,” says Dr. Kenderian.

With support from the Mayo Clinic Center for Individualized Medicine, Dr. Kenderian’ s team is investigating ways to expand CAR T-cell therapy beyond blood cancers to solid tumors and to autoimmune diseases like colitis.

Fighting cancer with genetically engineering cells

CAR T-cell therapy seeks to harness the power of the immune system by genetically modifying cells, equipping them with power to kill cancer. These synthetic cells act like a living drug that uses the body’s defense system to fight disease.

“This is a prime example of individualized immune therapy. Immune system T-cells are taken from each patient and engineered with an artificial protein that supercharges them to recognize and attack cancer. A large number of these cells are then injected back into the body. It’s a therapy shaped to each patient,” Dr. Kenderian says.

CAR T-cell therapy may be used on lymphoma and leukemia patients whose cancer has returned twice and no longer responds to standard therapy. Studies are underway to investigate whether it would be beneficial to start CAR T-cell therapy earlier.

One focus of Dr. Kenderian’s research is the “next generation” of CAR T-cell therapy. The research is looking for treatment with fewer side effects, lower cost, and use on solid tumors.

“The first challenge with that is unlike blood cancers, there is no unique protein or marker on the cancer cells for the CAR T-cells to attack. The second challenge is that solid tumors have a unique environment that is able to shut down the CAR T-cells. We hope to advance our understanding about this within the next five years,” he said

Fascinated with the immune system

Part of Dr. Kenderian’s dream was to practice medicine in the United States. After completing his residency at Michigan State University McLaren Hospital, he came to Mayo Clinic for a fellowship in hematology and oncology. It was during that time he grew fascinated with the power of the immune system and the potential that a patient’s body could fight disease.

“Tapping the immune system is perhaps one of the only therapeutic strategies that we can talk about as a potential cure (for cancer),” he says.

As part of his fellowship, Dr. Kenderian studied under the pioneers of CAR T-cell therapy at the University of Pennsylvania. He returned in 2016 to help establish the CAR T therapy program at Mayo Clinic.

Mayo is a leader in CAR T-cell therapy

Mayo Clinic is now one of a select few medical centers in the United States to offer CAR T-cell therapy in a clinical setting.

“Mayo Clinic is unique in this setting, because we have the clinical infrastructure to deliver the CAR T-cell therapy. And we have a solid interdisciplinary collaboration between basic science, clinical sciences and translational approaches to bring these discoveries to the clinic,” he says.

CAR T-cell therapy will be showcased at this year’s Individualizing Medicine Conference.

Sponsored by the Mayo Clinic Center for Individualized Medicine, the conference will be held on Sept. 12-13 at the Mayo Civic Center in Rochester.  You can register to attend here.

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Tags: B-cell lymphoma, CAR T-cell therapy, Dr. Saad Kenderian, immunotherapy, Innovations, Leukemia, Mayo Clinic Center for Individualized Medicine, News, People

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