Cell Therapy Stirs Hopes for Tumor Cure, but How to Make it Affordable for Patients?(AI Translation)

【周刊提前读】细胞疗法点燃治愈肿瘤希望 如何让患者用得起？

Peking University Cancer Hospital sees nearly a million outpatient visits annually [para. 1]. With the advent and improvement of therapies like cell therapy, some cancer patients have become the lucky ones [para. 1]. While life expectancy is increasing, so is the incidence of cancer. In China, every minute sees 9 diagnoses and 5 deaths due to cancer, with 70% of these deaths attributed to lung, liver, stomach, colorectal, and esophageal cancers [para. 2]. Scientists are exploring cellular therapies to combat these cancers, with clinical trials conducted at institutions like Peking University Cancer Hospital [2, 3].

The history of cancer treatment has evolved from surgery, radiotherapy, and chemotherapy to targeted and immunotherapies. By 2014, immunotherapy, particularly immune checkpoint inhibitors like PD-1, became prominent by leveraging the body's immune system [para. 4]. Currently, cell therapy is considered the "crown jewel" of immunotherapy, offering genuine hope of curing cancer [5, 6].

Cell therapy, part of immunotherapy, involves collecting immune cells from patients or donors, then activating or modifying them to enhance their ability to attack cancer cells [para. 8]. T cells are primarily used, giving rise to CAR-T, TIL, and TCR-T therapies [para. 9]. CAR-T therapy has been effective in treating blood cancers, providing clinical cures for many patients [para. 10]. Now, attention is turning to solid tumors, which account for more than 90% of all cancer cases [para. 11-13].

However, the high cost of cell therapy remains a significant issue. In the United States, the cost ranges from $300,000 to $500,000, and in China, it's between 1 million to 1.3 million yuan [para. 18]. This steep price means the therapy isn't covered by national health insurance in China [para. 19].

The industry is also taking note of the promising developments in TIL and TCR-T therapies. The world's first TIL therapy was approved in February 2024 for treating melanoma, with some patients showing lasting tumor shrinkage [21, 22]. Similarly, TCR-T therapy saw a breakthrough when Adaptimmune's product for advanced synovial sarcoma received FDA priority review status in January 2024 [para. 59].

Despite these advances, challenges remain in treating solid tumors with cell therapy. These tumors create a complex microenvironment that protects cancer cells and makes it challenging for T cells to remain active and effective [37, 40]. Companies are exploring combination therapies and other innovative approaches to enhance the efficacy of CAR-T therapy for solid tumors [41, 42].

Another challenge is making cell therapy more affordable and accessible. Reducing costs typically involves developing domestic substitutes for imported equipment and reagents, which are currently about half the price [para. 87]. Regulatory agencies are gradually opening the door for domestic substitution, providing a significant opportunity for cost reduction [para. 90].

The future lies in innovating to create universal cell therapy products that do not rely on patient-specific cells, which could drastically lower costs and improve accessibility [para. 93]. AI and advanced sequencing technologies could contribute to developing highly personalized TCR-T therapies [77, 80].

In summary, while there have been promising breakthroughs in cell therapies like CAR-T, TIL, and TCR-T, particularly for blood and some solid tumors, significant challenges remain regarding cost, accessibility, and consistent efficacy. Future strategies will likely focus on technological innovation and regulatory adjustments to ensure these life-saving treatments benefit a broader patient population [16, 19, 37, 40, 93].