How a ‘Living Drug’ Could Treat Autoimmune Disease

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How a ‘Living Drug’ Could Treat Autoimmune Disease
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CAR-T therapy has been successful at treating cancer. Now, it’s driven lupus into remission in a handful of patients.

The new study suggests a possible treatment for lupus patients who don’t benefit from currently available drugs. “This impressive study adds to the growing body of evidence that CAR-T therapy may be a therapeutic option for diseases beyond cancer, including autoimmune disorders such as lupus,” Jonathan Epstein, executive vice dean and chief scientific officer of the University of Pennsylvania’s Perelman School of Medicine, wrote to WIRED via email.

, but relapse remains common and occurs in 40 to 50 percent of patients. Cancer patients treated with CAR-T therapy can also have a severe inflammatory reaction called cytokine release syndrome. In the lupus study, patients experienced only mild side effects, including fever. “The difference between cancer and autoimmunity is that in cancer, there are usually more cells involved,” says Georg Schett, vice president of research at the University of Erlangen-Nuremberg in Germany, who was part of the study team. When engineered T cells go after so many tumor cells at once, it can over-activate the immune system and release a potentially life-threatening cytokine storm.

Schett’s team is planning a larger study called a basket trial, in which patients with different types of autoimmune conditions, such as rheumatoid arthritis and scleroderma, will be treated with CAR-T therapy. He says longer follow-up in larger clinical trials will be needed to determine whether the therapy is really a cure.for the foreseeable future. Currently, CAR-T therapies for cancer cost around $400,000 for a one-time infusion.

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