Medical Bulletin 7/November/2022

CAR-T, short for chimeric antigen receptor T-cell therapy, enlists immune cells called T cells to fight multiple myeloma by altering them in the lab so they can find and destroy cancer cells. It has been a revolutionary treatment for this deadly cancer, but some patients relapse after receiving CAR-T therapy and have no good treatment options afterward.

Mount Sinai and Memorial Sloan Kettering Cancer Center (MSK) researchers have identified therapies that can help patients with the blood cancer multiple myeloma who try an immunotherapy known as CAR-T only to find their cancer coming back afterwards.

In a new study published in the journal Blood in November, the researchers studied a large group of multiple myeloma patients who were given several different therapies when they relapsed after receiving a type of CAR-T cell therapy called BCMA-directed CAR-T. This version of CAR-T cell therapy targets the BCMA protein on cancerous plasma cells in order to fight multiple myeloma.

Reference:

Samir Parekh et al, JOURNAL Blood

Potential secret to viral resistance unearthed

Between 1977-79 in Ireland, several thousand women were exposed to the hepatitis C virus through contaminated anti-D, which is a medication made using plasma from donated blood and given to Rhesus negative women who are pregnant with a Rhesus positive foetus. The medication prevents the development of antibodies that could be dangerous in subsequent pregnancies. Some of the anti-D used during the 1977-79 period was contaminated with hepatitis C.

From this outbreak, three groups of people were identifiable: those who were chronically infected; those who cleared the infection with an antibody response; and those who appeared protected against infection without making antibodies against hepatitis C.

Scientists from Trinity College Dublin have unearthed a secret that may explain why some people are able to resist viral infections, having screened the immune systems of women exposed to hepatitis C (HCV) through contaminated anti-D transfusions given over 40 years ago in Ireland.

Reference:

Cliona O'Farrelly et al,Cell Reports Medicine, DOI 10.1016/j.xcrm.2022.100804 This article is under embargo.

Three weeks of radiation therapy instead of five yields comparable results for patients with non-metastatic soft tissue sarcoma

A major side effect of pre-operative radiation therapy in patients with non-metastatic STS is an increased risk of wound-healing complications after surgery. Patients have a heightened risk of needing a second operation for wound repair, extensive wound management and readmission to the hospital.

Patients with non-metastatic soft tissue sarcoma (STS) who need pre-operative radiation therapy can safely receive hypofractionated treatment over three weeks instead of five, with comparable tumor control and no increased risk of major complications in wound healing, according to researchers at The University of Texas MD Anderson Cancer Center.

Results from the study, led by Ashleigh Guadagnolo, M.D., professor of Radiation Oncology, were published today in The Lancet Oncology. Guadagnolo also presented results at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting.

Reference:

Ashleigh Guadagnolo, et al,Hypofractionated, 3-week, preoperative radiotherapy for patients with soft tissue sarcomas (HYPORT-STS): a single-centre, open-label, single-arm, phase 2 trial,JOURNAL The Lancet Oncology