CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy is one example of an immunotherapy that is offering new hope to some lymphoma patients. CAR T-cell therapy involves removing white blood cells called T cells from a patient’s body, genetically modifying the cells in a lab, and then infusing them back into the patient. Unlike a pharmaceutical with a defined chemical formulation, each batch is made from living cells of an individual patient.

This therapy is approved for people who have failed at least two lines of treatment for several kinds of non-Hodgkin’s lymphoma: diffuse large B-cell lymphoma (DLBCL), primary mediastinal large B-cell lymphoma (PMBCL), high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma. Duke Cancer Institute was one of the earliest treatment centers certified to administer CAR T-Cell therapy when it was approved by the FDA in October of 2017.

Many Studies Underway

CAR-T therapies for some solid tumors are in clinical trials. The Preston Robert Tisch Brain Tumor Center is studying a CAR-T therapy for glioblastomas, a type of brain cancer.

Duke investigators also have several studies under development to learn how to use immunotherapies to target cancer and to the ramp up the immune system to fight cancer.

Seeking Collaborators

The Duke Cancer Institute Center for Cancer Immunotherapy is interested in potential opportunities for collaboration from the bench to the bedside across the entire spectrum of cancer types. We are actively looking for the development of strategic research partnerships to generate scientific synergy.  Whether there is interest in translating a concept into a different scientific field or building research teams for future grant proposals, the Duke Center for Cancer Immunotherapy is interested in helping investigators through the process.

From Bench to Bedside

The DCI Center for Cancer Immunotherapy aims to speed up the process that brings immunotherapies for cancer from the bench to the bedside. We’ve been able to accomplish in six months what might take years at another institution by drawing on the collaborative talent of Duke investigators. Our investigators are engaged in every step of the process, from conducting lab studies to designing clinical trials and manufacturing a drug. We are open to collaborating with research partners across the world to broaden the scope of cancer patients who may benefit from immunotherapy treatment.

More research efforts are under development at our center, including new lung cancer immunotherapies and immunotherapies that will fight head and neck cancer, upper gastrointestinal cancer, colorectal cancer with metastasis to the liver, melanoma, and bladder cancer.

Immunotherapy Resistance

The Hanks Lab, run by Brent Hanks, MD, PhD, immunotherapy resistance. Understanding why some patients respond to immunotherapy and others don’t may guide the development of novel strategies to overcome resistance and expand the number of patients who can respond to immunotherapy.

Ongoing research in the Hanks Lab focuses on understanding how malignancies develop their own strategies for evading anti-tumor immunity and becoming resistant to currently available immuno-therapeutics. The lab utilizes both genetically engineered tumor models as well as clinical specimens from patients undergoing immunotherapy to guide their research. The group is currently conducting studies in melanoma, non-small cell lung cancer, and colorectal cancer.

This area of investigation holds great promise for using immunotherapies to treat people with cancer.

Immunotherapy Toxicity

Brent Hanks, MD, Ph.D, Andrew Nixon, Ph.D., and Jennifer Choe, MD, Ph.D., are collaborating on a biobank to understand why some patients develop autoimmune responses that inflame the gastrointestinal tract, lungs, and liver, or lead to the destruction of endocrine glands, including the thyroid and pituitary. The biobank collects blood and tissue samples, and data on reactions, from Duke cancer patients treated with immunotherapy for various cancer types. Data from this project will help predict which patients are at risk for side effects so they can be proactively managed or even prevented.

Disease-Specific Research Projects

Several projects are underway to study immunotherapies in breast cancer, gastrointestinal cancers, genitourinary cancers, lung cancer, and melanoma.

Novel Therapeutics Development

The Hanks Lab is working to develop drugs that target and manipulate dendritic cells to boost immune responses to checkpoint inhibitor therapy.

Georgia Beasley, MD, a surgical oncologist, is conducting clinical trials evaluating intra-lesional therapeutics such as oncolytic viral vectors to help manage patients with advanced melanoma. She is conducting clinical studies evaluating these agents that have been developed by other biotech companies.

April K.S. Salama, MD, leads ongoing clinical efforts to improve the management of patients with melanoma that has spread to the brain.