World-first NZ study: How new gene editing tech can boost smart cancer drugs
Itβs one of the biggest breakthroughs of our lifetime: clever drugs trained to harness the power of our own immune system and unleash it against
cancer cells as they attack us.
But, while immunotherapies like the well-known
Keytruda are
revolutionising cancer treatment, theyβre still only effective in about a third of patients - and scientists donβt yet know why.
βWhen immunotherapies are successful, theyβre super-successful - but thereβs still a massive 70 per cent of patients who donβt respond to therapy,β said Dr Hilary Sheppard of the University of Aucklandβs School of Biological Sciences.
To help solve that mystery, her team plan to turn to another of our generationβs biggest game-changers - Crispr Cas-9
gene editing - to deeper explore an immune cell pathway that most immunotherapies target.
Their new study, just awarded a $940,000 grant from the Marsden Fund, could ultimately help improve the effectiveness of these drugs - with implications that reach well beyond cancer treatment.
βWhat weβre interested in is this particular pathway, called the PD-1 pathway, thatβs activated in any situation of chronic immune stimulation - whether thatβs cancer, chronic infection, or autoimmunity,β Sheppard explained.
βIf youβre healthy, your immune system can kill rogue cancer cells.
βBut cancer cells can also fight back using a suppressive mechanism that we can think of as a lock and key system - that is, locks on the cancer cell, called ligands, that engage with keys on the immune cells, called receptors.β
When the lock and key are engaged, it effectively dampens down the immune system - and the roving hunter-killer T-cells within it - as it tries to stamp out cancer cells spreading in our bodies.
Within the PD-1 pathway, cancer patients have been found to have varying levels of a key molecule - and just how these different levels affect treatment outcomes, or establish lasting immunity, remains a mystery.
βWhile youβd think that patients whose PD-1 pathways are very active would respond very well to immunotherapy drugs, that isnβt always the case,β Sheppard said.
βThen, in other patients where that pathway doesnβt seem to be as active, the immunotherapy drugs can work - so thereβs a lot we donβt understand about it.β
This is where Sheppard and her team planned to employ Crispr Cas-9 β a system that can be used like molecular scissors to splice and snip genes, or insert new ones - on in-vitro samples in the lab.
βUsing the standard techniques that we employ to understand gene expression, we either knock out a gene completely, or we over-express it at wildly high levels, way beyond physiological levels,β she said.
In this case, the team didnβt want to edit out the troublesome pathway completely, as this could cause adverse effects like auto-immunity.
βRather, what weβre trying to do is fine-tune the system to find that sweet spot thatβs going to allow for the specifically targeted killing of the cancer without having any adverse effects.β
As far as Sheppard was aware, this sort of editing had never been performed on endogenous genes before - nor in human T-cells.
But more exciting was the studyβs potential to unlock major new insights into a vast range of diseases and disorders involving our immune system - all of which could advance new clinical treatments.
βUnderstanding this pathway has implications for multiple immune conditions.β
Can gene editing help unlock the power of ground-breaking immunotherapy cancer drugs?
www.nzherald.co.nz
Reading online, there are some amazing advancing being made with immunotherapies and genetherapies. While the science is pretty much only in itβs infancy, itβs hoped that a number of cancers currently dealt with by chemotherapy would instead would use these new treatments which are far more tolerated than chemo.
The Malaghan Institute in Wellington are currently running trials on CAR T-cell treatments for some cancers.
www.malaghan.org.nz