Cell therapy represents a frontier in medical treatment, offering new possibilities by harnessing the power of living cells to combat disease. This innovative approach moves beyond traditional pharmaceuticals, using the body’s own biological mechanisms to restore health. Bristol Myers Squibb (BMS) is a prominent contributor in this rapidly evolving field, developing advanced cellular therapies. Their efforts focus on treatments that reprogram the immune system to target specific diseases.
Understanding Cell Therapy and BMS’s Contribution
Cell therapy broadly involves administering living cells to a patient to prevent or treat a disease. These cells can be derived from the patient themselves (autologous) or from a donor (allogeneic), encompassing various cell types such as stem cells or immune cells. BMS has focused its research and development on advanced cellular immunotherapies, pioneering Chimeric Antigen Receptor (CAR) T-cell therapy. BMS has over 20 years of experience in this field.
CAR T-cell therapy involves modifying a patient’s own T-cells, a type of white blood cell, to recognize and eliminate diseased cells. This personalized approach reprograms the patient’s immune cells for a targeted attack. The overarching goal is to enhance the immune system’s ability to identify and destroy specific threats, such as cancer cells. BMS is a leading developer in the cell therapy landscape, with two approved CAR T-cell therapies addressing distinct blood cancers.
Mechanism of BMS Cell Therapies
BMS’s CAR T-cell therapy begins with the collection of a patient’s T-cells through a process called leukapheresis. During leukapheresis, blood is drawn from the patient, T-cells are separated, and the remaining blood components are returned to the patient’s body. These collected T-cells are then sent to a specialized manufacturing facility.
In the laboratory, the T-cells undergo genetic modification to express a Chimeric Antigen Receptor (CAR) on their surface. This CAR is an engineered receptor designed to specifically bind to proteins, or antigens, found on the surface of target cells, such as cancer cells. Once modified, these CAR T-cells are multiplied to create a therapeutic dose of millions of re-engineered cells. These expanded CAR T-cells are then returned to the patient, where they can recognize, target, and destroy cells expressing the specific antigen.
Treatable Conditions with BMS Cell Therapy
BMS’s approved CAR T-cell therapies are primarily used for treating specific blood cancers. These include certain types of lymphoma, such as relapsed or refractory large B-cell lymphoma and mantle cell lymphoma, and multiple myeloma. These cancers are targeted because their cells often express specific antigens, like CD19 for certain lymphomas and leukemias, which the engineered CAR T-cells recognize.
For instance, Breyanzi (lisocabtagene maraleucel) is approved for adult patients with relapsed or refractory large B-cell lymphoma and mantle cell lymphoma, making it a widely applicable CAR T-cell therapy. Abecma (idecabtagene vicleucel) is another CAR T-cell therapy from BMS approved for multiple myeloma. Research is also ongoing to explore the effectiveness of CAR T-cell therapy in treating certain autoimmune diseases.
The Patient Journey and Care
The patient journey for BMS cell therapy involves several distinct stages, beginning with an initial evaluation to determine eligibility for the treatment. Following eligibility, the patient undergoes cell collection, a process known as apheresis, where their T-cells are harvested. These collected cells are then sent to a manufacturing facility, where they are genetically modified and expanded.
Before the reinfusion of the modified cells, patients typically receive a short course of conditioning chemotherapy. This lymphodepleting chemotherapy helps prepare the body to accept the reprogrammed CAR T-cells by creating space in the patient’s immune system. The personalized CAR T-cells are then infused back into the patient. Following infusion, patients are closely monitored for potential side effects, which can include cytokine release syndrome (CRS) and neurotoxicity. CRS can manifest with symptoms like fever, fatigue, chills, and low blood pressure, while neurotoxicity may present as confusion, difficulty speaking, or seizures. Patients receive specialized care and supportive measures throughout the recovery period.