[HN Gopher] What we are doing today with CAR-T cell therapy agai...
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       What we are doing today with CAR-T cell therapy against cancer
       seems like SciFi
        
       Author : belter
       Score  : 41 points
       Date   : 2023-11-03 19:55 UTC (3 hours ago)
        
 (HTM) web link (english.elpais.com)
 (TXT) w3m dump (english.elpais.com)
        
       | procarch2019 wrote:
       | I work in the OT/automation space for pharma. Cell and gene
       | therapy is crazy amazing.
       | 
       | One thing I didn't really see mentioned here is length of
       | treatment. They have to collect patients sample at hospital or
       | other facility, transport to production facility, grow sample,
       | inject sample with vector, grow some more and then reintroduce.
       | The real sci-fi moment will be when they get to the point they
       | can treat in a day.
       | 
       | I think most are 3+ weeks sample to treatment right now. Still
       | amazing though.
        
         | jfarlow wrote:
         | There are a number of companies working on 'in vivo' deliveries
         | for CARs. Oftentimes using the same tools as proven out by the
         | Moderna vaccine.
        
           | puzzlingcaptcha wrote:
           | Yes, but that way you lose control over the dose, and to an
           | extent over CAR-T characteristics. CAR-T therapy is usually
           | used in patients who already had multiple rounds of chemo and
           | their immune cells are generally not in a great shape. Even
           | with 'traditional' CARs you occasionally get manufacturing
           | failures since the cells are too exhausted to expand in vitro
           | or have already lost their effector functions.
        
         | puzzlingcaptcha wrote:
         | The 'vein-to-vein' time (apheresis to infusion) is being
         | shortened all the time, and you can already manufacture CAR-T
         | cells in 24-48hrs, but it still takes about a week to clear
         | quality assurance and release the product (microbiology,
         | integrated copy number, integration site testing, autonomous
         | growth potential etc). The reason being mostly that you don't
         | want to accidentally replace patient's B cell cancer with a T
         | cell cancer of your own making.
        
         | derefr wrote:
         | > The real sci-fi moment will be when they get to the point
         | they can treat in a day.
         | 
         | How do you imagine that would work?
         | 
         | Some closed-pipeline machine that lives in the hospital and
         | automates sample - modified sample culture cycle?
         | 
         | Or something stranger, e.g. some kind of injectable (maybe
         | prokaryotic?) cells that actively swim around looking for
         | L-lymphocytes to vectorize through bacterial horizontal gene
         | transfer -- such that the whole process happens _in vivo_?
        
           | puzzlingcaptcha wrote:
           | > Some closed-pipeline machine that lives in the hospital and
           | automates sample - modified sample culture cycle?
           | 
           | That's already a thing, for example Lonza's Cocoon platform
           | or Miltenyi's Prodigy (both are often used for on-site
           | manufacturing).
        
         | orochimaaru wrote:
         | Considering leukemia treatment today is 2 years for girls and 3
         | years foe boys, 3weeks is several magnitudes worth of
         | improvement.
        
           | puzzlingcaptcha wrote:
           | The treatment itself is a one-day procedure (although the
           | patients will be generally kept under observation for CRS for
           | a few days and then regularly monitored for response), the 3
           | weeks is the time needed for manufacturing/QC. In that time
           | patients receive bridging chemotherapy until the CAR-T
           | product is ready and unfortunately some do not make it.
        
       | dendrite9 wrote:
       | I am watching someone go through this treatment at the moment. I
       | was trying to describe the process to a friend and after giving
       | my understand had to follow up with "it seems fantastical, or
       | like magic, in a way that is hard to wrap my head around."
       | 
       | The monitoring time post treatment seems like it might be a
       | bigger bottleneck than the production time but it could be that
       | as the side effects and likelihoods are better understood then
       | that level attention might be reduced. I was told that currently
       | there are only two production facilities, one on each side of the
       | country.
       | 
       | During the blood collection recently one of the nurses talked
       | about the possibility to work on sickle cell anemia and how they
       | were hoping to start treating people.
       | https://www.npr.org/sections/health-shots/2023/10/31/1208041...
        
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       (page generated 2023-11-03 23:00 UTC)