Manel Juan

CAR-T cell-based treatments have been successful against some blood tumours, but are much less effective for solid tumours. A phase 1 clinical trial has tested their use in 11 children and young adults with diffuse midline glioma, a tumour of the nervous system that is considered incurable. The results, published in the journal Nature, indicate that the treatment improved functional status in nine of the 11 patients. One of the four who showed a strong response is still healthy four years later.

The regulatory agencies for medicines in the United States and Europe have issued statements informing about a possible risk of developing certain types of tumors following CAR-T cell immunotherapy treatment. What do we know so far? What is the real risk? Does the benefit-risk balance still hold? Has anything changed after these alerts? We answer these questions with expert opinions and the data currently available. 

CAR-T cell therapies may, in some cases, produce tumours secondary to treatment. A few months ago, the US Food and Drug Administration (FDA) said it was assessing this risk. Now, a study conducted at Stanford University Medical Center (USA) has tracked 724 patients who received this type of treatment since 2016. Of these, 14 developed another blood tumour, but only one was a T-cell lymphoma that could be a direct consequence of the therapy. Further analysis ruled out this link. The results are published in the journal NEJM. 

The Karolinska Institute has awarded the Nobel Prize in Medicine or Physiology to Katalin Karikó and Drew Weissman for their groundbreaking discoveries, which have radically changed our understanding of how mRNA interacts with our immune system, and made it possible to develop vaccines at unprecedented speed during the covid-19 pandemic.

A phase 1 clinical trial has tested personalised mRNA vaccines against the most common type of pancreatic cancer with a particularly poor prognosis. The treatment, which is tailored to the characteristics of each patient's tumour, was given to 16 people along with surgery, chemotherapy and other immunotherapy. Half of them showed an immune response to the vaccine, which was associated with a better prognosis. The results are published in the journal Nature.

Two preclinical studies published in the journal Science have introduced new bioengineered modifications to CAR-T cells in an attempt to make them more potent and safer in their anti-tumour action. These variations allow their activity to be enhanced only in the vicinity of the tumour or their actions to be regulated on demand.

A pioneering phase 1 clinical trial has tested a type of cancer immunotherapy. Researchers have modified patients' own T-lymphocyte receptors using the CRISPR tool to direct them against specific targets on their own tumours. The results are published in the journal Nature.

US researchers have designed an intranasal vaccination device that is capable of delivering immunising proteins through the mucosal surface. The research, published in Science Translational Medicine, shows that strong antibody responses against viruses such as HIV and SARS-CoV-2 have been achieved in mice and non-human primates.

The director of the Vaccine Strategy of the European Medicines Agency (EMA), Marco Cavaleri, told a press conference on 11 January that "it is not sustainable in the long term to continue giving booster doses every three or four months [to the general population]". Spanish immunologists agree that this is not the right thing to do. In these reactions they explain why.

The first solid work on the ability of vaccines to stop infection with the omicron variant, which has just been published, reinforces the need for a third dose. Experts recall, however, that the aim of vaccines was never to stop infection, but to prevent severe disease. We summarize what is known so far about it.