More than 500 blood cancer patients have been treated since 2017 with advanced CAR-T immunotherapies at Hospital Clínic-IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer). These patients were in very advanced stages of the disease and had few treatment options left. These new cellular therapies, developed by the healthcare center itself, have proven effective in more than half of the cases, as tumor cells have completely disappeared in more than 50% of patients.
Immunotherapy is one of the most revolutionary treatments for cancer, as it acts on the patient's own immune system. Specifically, CAR-T therapy ---named after the English acronym for Chimeric Antigen Receptor--- uses the patient's own immune system's T cells to directly attack cancer. Thus, these cells are extracted from the blood, genetically modified in the laboratory, and then re-administered to recognize and attack tumor cells.
Since the program's inception in May 2017, more and more patients are being treated each year at Hospital Clínic, reaching one hundred cases annually. The diseases for which they have been treated are acute lymphoblastic leukemia, multiple myeloma, and non-Hodgkin lymphoma; all of them different types of blood cancer.
In these cases, the treatment has achieved complete remission of cancer in more than half of patients and, in some types of disease, such as acute lymphoblastic leukemia, this figure rises to 90%. For this type of tumor, Hospital Clínic has also followed up for four years and has been able to verify that the cancer not only disappears from the body but, in a third of patients, does not reappear. "We managed to rescue patients who had little life expectancy," emphasized Dr. Álvaro Urbano, coordinator of the CAR-T Program at Clínic-IDIBAPS.
From the Barcelona center, they have also highlighted that these are 100% public therapies, developed by the hospital itself, and to which patients from all over Spain can access. In fact, more than 70% of the cases came from other hospitals. "Producing an effective CAR-T, with a distribution network and financed by the public system is unique in the world. We are being a model for other countries," highlighted Dr. Urbano. Treatments to which it is estimated that only 6% of patients in the most developed countries can access.
These therapies have been created within the framework of the ARI project, named after Ariadna Benedé, a young patient who died of leukemia in 2016 and who gave hope to the hospital in the research of this therapy. Since May 2017, when the first infusion of a CAR-T treatment was performed, Clínic-IDIBAPS has led the development of several innovative immunotherapies.
Two of these therapies are already approved by the Spanish Agency of Medicines and Medical Devices (AEMPS), making the Barcelona center the only hospital in Europe that has fully developed two academic (non-commercial) therapies approved by a regulatory agency. Specifically, they are ARI-0001, indicated for adult patients with resistant acute lymphoblastic leukemia, and ARI-0002, for resistant multiple myeloma.
For the development of these therapies, public-private collaboration has been essential, as the project has had the support of the La Caixa Foundation, through an alliance worth 8.5 million euros that promotes the CaixaResearch Immunotherapy Research Unit, and the Carlos III Health Institute (ISCIII).
In addition, the Clínic has already launched new clinical trials for the application of CAR-T to other types of tumors, such as ARI-0003, a dual treatment aimed at attacking two different therapeutic targets present in malignant cells, and even applying this therapy to treat breast cancer.