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Each T cell's TCR is specific to one antigen and sits on the T cell's surface. The affinity of human TCRs to tumor antigens is relatively low, rendering them unable to recognize and kill tumor cells effectively. The modified T cell has much higher affinity, which enhances both recognition and affinity supporting the recognition of tumor cells. [1]
The CAR programs the T cells to target an antigen present on the tumor cell surface. For safety, CAR T cells are engineered to be specific to an antigen that is expressed on a tumor cell but not on healthy cells. [2] After the modified T cells are infused into a patient, they act as a "living drug" against cancer cells. [3]
The T-cells can optionally be modified in various ways, cultured and infused into patients. T cells can be modified via genetic engineering, producing CAR-T cell or TCR T cells or by exposing the T cells to tumor antigens in a non-immunosuppressive environment, that they recognize as foreign and learn to attack.
The patient’s T-cells are genetically modified in laboratories to include chimeric antigen receptors (CARs). The CARs are designed to recognize the specific cancer antigens and bind to them, allowing T-cells to target and attack the cancer cells. The genetically modified T-cells are administered back to the patients as a treatment.
Although T- cells are powerful tools that help us defend against cancer through immune responses, errors may still occur during the process, and cancer's anti-tumour effect may vary. For example, the T- cells may not be activated and sustain the anti-tumor effect long enough, or the number of T-cells presented is insufficient.
In October, Chinese scientists reported they had started a trial to genetically modify T cells from 10 adult patients with lung cancer and reinject the modified T cells back into their bodies to attack the cancer cells. The T cells had the PD-1 protein (which stops or slows the immune response) removed using CRISPR-Cas9. [242] [243]
The diagram above represents the process of chimeric antigen receptor T-cell therapy (CAR), this is a method of immunotherapy, which is a growing practice in the treatment of cancer. The final result should be a production of equipped T-cells that can recognize and fight the infected cancer cells in the body.
The dendritic cell-based cancer vaccine is an innovation in therapeutic strategy for cancer patients. Dendritic cells (DCs) are antigen presenting cells for the induction of antigen specific T cell response. [1] DC-based immunotherapy is safe and can promote antitumor immune responses and prolonged survival of cancer patients. [2]