At the moment, Chimeric Antigen Receptor Therapies are considered as last option for patients, who prior didn’t respond well to established treatments. Reasons are the lack of information about the long term effects of the therapy due to the yet young approach, which therefore still implies an experimental character. Other obstacles are the high manufacturing and merchandising costs, which hinders the CAR Therapy for financial reasons to be considered as a part of an elaborated cancer therapy in combination with established onsets.

We are convinced that by this project, we can contribute to the acceptance and establishment of Chimeric Antigen Receptor therapies in general and hence want to address the mentioned aspects above.

Safety

Based on our experience from the Science Fair, people recognized our efforts in improving the safety and the compatibility of a novel cancer therapy. Yet, as a population with no expert knowledge in this field, they were interested by the prospect of introducing genetically modified immune cells to specifically target and destroy cancer.

In order to address these thoughts and concerns, we consulted with an expert work group on CAR T cells, the work group from Prof. Dr. Toni Cathomen from the Center of Chronic Immunodeficiency. This institute is dedicated to the research and research of the immune system and rare immune diseases. With their contribution, we were able to establish a kill switch, which specifically eliminates our modified t cells in case they show unexpected behaviour.

Acceptance and long term side effects

Improving our project by consulting experts was a central part of our human practice. Another critical point is how those who hopefully will benefit from our project will perceive the idea. For that purpose we contacted PD Simone Hettmer from the Cancer Comprehensive Center Freiburg, one of 13 oncology centers of excellence in Germany.

Her field of activity is located on Pediatric hematology and oncology, and she also is a spokeswoman for the center for young adolescents after cancer. This institution advocates for the treatment of long-term survivors of cancer, and therefore she can provide us with first hand-information on how patients or their parents would perceive our project idea.

Costs and further Development

The first approved CAR-Therapy manufactured and merchandised by Novartis (Tisagenleucel) in the United States would cost 475 000 $ excluding the hospitalization costs, predrug administrations and follow-up care. Estimated costs for 1 year are about 547 000 $ (Hagen, 2017).

Despite of the imminent prospect of death, not every health insurance is willing to cover such amounts. Additionally, it is approved specific against acute lymphoblastic leukemia.

Car T cell treatments for solid tumors are still under clinical trials, because they are difficult to address partly due to their immunosupressive tumor microenvironment.

As it is the first approved CAR therapy, we touched on possibilities for optimisation and automatisation of manufacturing protocols. This is a critical step to make the CAR therapy affordable and ready to use at every treatment center. We had an interview with Prof. Dr. Tony Cathomen from the CCI to talk about the prospects and future developments to establish the CAR therapy as an integral part of Cancer therapies and also to make it suitable for the treatment of solid tumors. Prof. Dr. Toni Cathomen is the director of the Institute for Transfusion Medicine and Gene Therapy in Freiburg, which collaborates with CARAT, Chimeric Antigen Receptor for Advanced therapies, a research collaboration funded by the European Union.