Cellular therapy is considered one of the angular treatments in our cancer fighting approach, becoming a real option for cancer management.
What is cellular therapy?
Also known as immunotherapy, autologous cellular therapy, or anti-cancer vaccines, cellular therapy is an accepted form of treatment, even mentioned in medical journals.
Within oncology, Immunotherapy is known as a group of drugs called monoclonal antibodies, which act through the immune system to attack malignant cells. It is important to mention that when using the term immunotherapy we are not alluding to this specific presentation.
Cellular therapy involves the use of patient-specific immune cells for the treatment of cancer.
Recall that the immune system is composed of white blood cells, this is a generic name that refers to a huge population of cells of different types and with different functions, all with a common end, the defense and repair of the human body.
These cells circulate throughout our body through the blood reaching all tissues and organs, thus maintaining order and integrity of the whole being. We can see our immune system as a great army, ready and armed to attack any enemy, within this cellular army we will recognize different types of “soldiers” each with a special quality and function within the immune response.
Cancer from the point of view of the immune system.
As we already mentioned, we define Cancer as a set of diseases that result in the formation of a tumor or tumors as a result of the uncontrolled multiplication of cells which do not recognize the cellular order imposed by the body for each system and organ.
We have also come to note that it is not only the set of diseases that constitute it, we also have identified 5 areas that are related within this etiology, with immunological dysfunction being a primary one.
Now, let’s see how the immune system sees what we call cancer. The human body consists of trillions of cells; they all correspond to a specific order to maintain the integrity and function of each organ and system. This through a cell cycle, where cells are produced to have a certain function, which in time will die to give way to new cells, and thus continue with the cell cycle until the end of life.
However, this massive production of cells destined to millions of different functions is not exempt from alterations, resulting in this abnormal production of non-functional cells, without corresponding to a cellular order, we also have an uncontrolled multiplication that is the causal behind the generation of what we call tumors which culminates in alterations in the organ-systemic-corporal function.
In response to this, the immune system has specific cells responsible for the recognition of these dysfunctional cells, eliminating them and thus avoiding their possible multiplication and damage. This in an ideal scenario, however, this system can fail to recognize these dysfunctional cells, giving way to their existence and multiplication.
Another way these dysfunctional cells have for their survival is the obstruction of the immune response, in other words, they “hide” from the immune system, thus avoiding recognition and hence the attack against them.
Now going back to the example of the immune system as an army, let us imagine that the cells in charge of battling these dysfunctional cells could be considered as “special forces” , now, these special forces in charge of mounting a battle against cancer cells are called T-cells, NK cells and LAK cells, these cells together with the rest of the cells that make up the immune system are able to mount a suitable response against malignant or dysfunctional cells to eliminate them.
How is the immune therapy performed?
Before explaining how the development of therapy is carried out, it is of great importance to recognize that the production / elaboration of this treatment requires not only the knowledge, training, preparation, experience and qualified medical personnel, but also of a series of technological equipment that allow the extraction, manipulation and preservation for the application of these cells, this mainly to safeguard patient safety and second to ensure the purity and effectiveness of the therapy.
It starts with a sample of peripheral blood, then, working at cellular level, we are able to isolate the required cells; in this case we will extract both specific white blood cells, as well as circulating malignant cells. If possible, we will also get malignant cells directly from the tumor for further presentation.
The next step is to work directly with the white cells, where we will first process them for incubation and insure their multiplication, in this step we will obtain trillions of these healthy cells, later they will be manipulated at a genetic level to help them prepare for the next step, the recognition of the malignant cell.
This step is of utmost importance since we are providing the white cell with the immunological information of the malignant cell so that it can first recognize it and then attack it.
The next series of steps are to ensure that our white cells are ripe and ready for application and action within the body; this process generally takes about 6 to 10 days after the peripheral blood sample is taken, In our particular case, and because we are pioneers in this area and have the necessary technological infrastructure and experience, we can develop different cell lines, that is, we can work with T-cells, NK cells and LAK cells, as well as combinations of all of these.
How is immune therapy administrated?
Once we have obtained the cell lines with which we will work, the application begins, and remember, we are working with live cells, which can only be maintained in two ways, either inside the body or as we explained, conserved in specialized equipment built for this purpose. So its immediate application once out of these artificial means of conservation is vital to its effectiveness. Emphasizing the paramount importance of patient safety.
The administration of the cellular therapy can be carried out through different techniques.
Systemic, which is the intravenous delivery of cells, and the most frequently used technique, this is achieved by applying the cells through a peripheral catheter.
Let’s not forget that regardless of tumor size or quantity, our battle is at the cellular level, this technique also gives us an advantage on areas where the presence of the cancer is merely microscopic.
Another advantage is in situations where distant activity or metastasis is present, that is, multiple areas to be treated.
The second technique is subcutaneous administration, this technique refers to the deposition of white cells in the subcutaneous space, this is between the skin and the fatty tissue. These are injected into specific areas of the body in reference to the location of the tumor. They can be applied to the upper body on the back of the arms, abdominal fat or thighs, depending on the location of the activity.
A third technique is intramedullary administration, unique for cancers of the blood or invasion of this by malignant cells coming from a solid tumor; this involves depositing the cells directly into the long bones. All are considered methods of minimal invasion.
Once inside the body the white cells will continue to replicate, to go in search of either tumor cells or attack the tumor directly, just like an army surrounds its enemy to later attack and destroy it.
Cell therapy does not produce severe side effects. It does not cause damage to other cells, this is, other white or red blood cells, it does not damage organs, it does not produce hair loss.
Its use is contraindicated on patients who have received recent full-dose chemotherapy, in cases where low-dose of chemotherapy has been administered, cellular therapy could be considered as an adjacent fighter, this requires a planned strategy and respecting certain times as to the application of one therapy over the other.
In the case of radiotherapy, a benefit has been observed, since immunological information is released during and after radiotherapy, from which the cellular therapy benefits, in some cases, increasing responsiveness and effectiveness.
Sources Cancer Immunotherapy in Mexico from Functional Oncology, Dendritic Cell Immunotherapy Stem Cell Mexico and Bio-Immune Cellular Therapy at Angeles Hospital Tijuana