AHN Engineers Immune Cells

Clinicians at the AHN Cancer Institute are taking a giant leap forward in CAR T-cell therapy.

Since 2019, they’ve been pushing aggressive blood cancers into remission by infusing these re-engineered T cells into patients. Now, rather than shipping patients’ cells to an outside lab for the manufacturing process, AHN has invested in sophisticated equipment that can transform the cells at West Penn Hospital.

“Having this technology here at our facility gives us a potentially lifesaving treatment for a patient who desperately needs something quickly,” said John Lister, MD, chief of the Division of Hematology and Cellular Therapy. “With CAR T-cell therapy, we can alter a patient’s own immune cells — one patient at a time — and then tell the cells, ‘Go find the cancer cells and wipe them out.’ This is truly a new dawn for cancer therapy and for personalized medicine.”

Transforming a Patient’s Own Cells to Fight Cancer

The immune system allows the body to recognize which cells are its own and which are not, killing off any foreign cells lurking in the body. But when someone develops cancer, especially blood cancer, the immune system can no longer recognize the cancer cells as foreign. And the more the cancer establishes itself, the more the disease develops ways of evading the immune system and the T cells seeking to eliminate it.

But experts at AHN are finding those cancer cells. Using CAR T-cell therapy, they can successfully fight some of the most challenging cancers, like leukemia and lymphoma. It could even turn a patient’s otherwise terminal diagnosis into a chance at remission

“The therapy involves connecting patients to a machine that spins their blood and collects the T cells,” Dr. Lister explained. “Then AHN scientists genetically reprogram these T cells in the laboratory by equipping them with chimeric antigen receptors (CARs) that enhance their ability to recognize cancer cells and kill them.”

The genetically modified T cells are incubated in the laboratory until they multiply into millions. Typically, 12 days after the cells were originally removed from the patient, doctors infuse the re-engineered cells back into the patient. The CAR T cells begin their mission, traveling throughout the body to eliminate cancer cells. It is a one-time infusion, although patients may remain in the hospital for several weeks while doctors monitor their response to treatment and side effects.

On-Site Capabilities Broaden Treatment Potential

AHN previously sent the cells to a drug company for the manufacturing process. Two weeks later, the facility returned the genetically altered cells to AHN in a frozen state. They were thawed and infused back into the patient.

This type of treatment is for patients who have unfortunately experienced a relapse of their cancer, and we have exhausted all other options,” Dr. Lister said. “Often, time is critical, and having the ability to produce the CAR T cells here and infuse them into the patient eight days later is extremely beneficial.”

Dr. Lister explained that the on-site capabilities also widen AHN’s opportunity to treat more patients through research protocols. Currently, CAR T-cell therapy is FDA-approved as a standard of care for some forms of aggressive, refractory lymphoma, such as diffuse large B-cell lymphoma, transformed follicular lymphoma, and mantle cell lymphoma. This therapy is also approved for patients with relapsed or refractory acute lymphoblastic leukemia up to age 25.

“By opening up a research protocol, we can treat patients who are outside these criteria and greatly expand the applicability of the medicine,” Dr. Lister said. “And, as new targeting strategies are discovered, we can pivot quickly to implement them potentially in other cancer types, such as breast cancer.”

AHN is the first health care system in the region* to manufacture CAR T cells. Though the treatment is exclusively provided at West Penn Hospital, it is available to any patient meeting the criteria for treatment.

“This is truly a new dawn for cancer therapy and for personalized medicine.” - Dr. John Lister

For more information on Car T-cell therapy, contact John Lister, MD at 412-352-2763 or john.lister@ahn.org

* Region refers to AHN’s primary and secondary service areas of Allegheny, Armstrong, Beaver, Butler, Crawford, Erie, Mercer, Washington, and Westmoreland counties