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When it comes to promising areas in the treatment of lymphoma and other blood cancers, gene therapy may be at the top of the list. Here’s why.
When it comes to promising areas in the treatment of lymphoma and other blood cancers, gene therapy may be at the top of the list.
“Gene therapy is the correction of alterations in genes,” says Gerald L. Messerschmidt, MD, FACP, chief medical officer of oncology at Precision for Medicine. “It will be the future of cancer therapy, but it is still not mainstream at this time.”
Still, current developments are bringing new levels of interest on the part of researchers, clinicians, and the public at large.
“It’s a very exciting time,” says William DeRosa, chief of oncology at Summit Medical Group MD Anderson Cancer Center in Florham Park, New Jersey. “We’re at the beginning of the beginning of a new era.”
Just what can healthcare execs look for in applications of gene therapy? Here are three ways this expanding area is improving cancer care.
1. Greater precision
The use of chimeric antigen receptor (CAR) T-cell therapy is bringing new levels of precision in cancer treatment. Because CAR T-cell therapies direct the potential of T-cell therapy toward specific targets, they allow for higher precision in treatments without the toxicity usually seen in common cancer treatments, says Julie Kaylor, MS, certified genetic counselor, client liaison on the genetic analyst team at InformedDNA in St. Petersburg, Florida.
“Historically, cancer is treated broadly, causing damage to healthy cells and producing a variety of negative side effects for the patient throughout treatment,” she says. “However, CAR T-cell therapy uses the patient’s individual genetic makeup to target and treat their cancer, reducing harm and side effects to the patient.”
She adds that these therapies truly represent a paradigm shift in cancer treatments, pointing out that the FDA recently approved two different autologous CAR T-cell therapies, and the American Society of Clinical Oncology named CAR T-cell therapy the “Advance of the Year” in 2018.
“This is all good news for patients with hematologic cancers that were not previously treatable with other methods,” Kaylor says.
2. More options
As progress continues, more options for treatment alternatives seem to be on the horizon.
“We may be on the verge of a breakthrough with gene therapies, particularly where CAR T-cell therapy is concerned,” Kaylor says. “These treatments add more weapons in the fight against cancer, but also put pressure on healthcare executives and providers to stay on top of these possibilities and discoveries to ensure they are making the best decisions as new therapies are introduced.”
At the same time, she points out that stakeholders should be prepared to continue monitoring outcomes of patients using gene therapy to understand the long-term effects. With careful analysis on an ongoing basis, managed care executives will be better prepared to make decisions around coverage and payments for these novel therapies, especially those with high list prices.
“Tapping into genetics expertise can help providers and executives decipher the wealth of information currently on the market to help make those clinical decisions,” Kaylor says. “This will allow patients the best opportunity to receive the positive outcomes that new gene therapies can provide.”
3. More hope
While gene therapy may be in its infancy, its potential can bring optimism for providers and hope to patients and their families. Behind such feelings is the evolution to new ways of approaching treatment.
“We’re moving away from a tissue-based approach,” DeRosa says. “Now we’re looking at mutations. “The only biology that matters is that individual person’s biology.”
With this approach, the likelihood of improved prognoses seems strong, even if gains are incremental rather than a dramatic home run.
“There’s tremendous reason to be optimistic,” DeRosa notes. “If we’re not able to cure diseases that were previously fatal, they will be regarded as chronic diseases that can be managed.”
Messerschmidt is also optimistic. “With further scientific advances, the discovery of more genetic targets, and new methodologies of delivering gene editing systems to malignant cells, resulting in more disease control, we can achieve longer survival and perhaps, cures,” he says.