2024-04-29 16:15:05
Saint-Louis Hospital, hemato-oncology department. From the 6th floor of this Assistance publique-Hôpitaux de Paris (AP-HP) vessel, anchored in the heart of the 10th arrondissement, the view looks south. An April sun bathes the roofs, from which emerge the dome of the Pantheon, the Center Pompidou, the Montparnasse tower in the distance. In a room dimmed by a makeshift curtain, a patient man is bedridden.
Nurse Alison De Almeida injects CART-T cell treatment into a 39-year-old lymphoma patient. She takes three minutes to administer the contents of the syringe. At the Saint-Louis hospital (AP-HP), in Paris, April 15, 2024. JULIE BALAGUÉ FOR “LE MONDE”
It’s been six days since Adam (first name has been changed), 39, was hospitalized once more. His lymphoma has relapsed and he is regarding to receive a sophisticated treatment with a strange name, “CAR-T cells” (pronounced “car-ti”), an acronym that we will detail below.
This therapy mobilizes tiny warriors, T lymphocytes. But rearmed warriors, trained for combat, transformed into “tumor-killing cells” by genetic modification. In the vast majority of cases, these T lymphocytes are first collected from the patient himself, then they are « educated” in the laboratory to recognize tumors. Once reinjected into the patient’s blood, they will target the tumor cells, like homing missiles, then activate to eliminate them. Better yet, they will multiply to increase their troops.
“This cell therapy is revolutionizing the treatment of many blood cancers”, rejoices Catherine Thieblemont, head of the hemato-oncology department at Saint-Louis hospital. The effectiveness can be ” spectacular “, offering prolonged remissions, or even cures, to patients hitherto condemned in the short term. And their indications might extend well beyond: in autoimmune diseases or solid tumors, very first trials are showing results “very encouraging”selon Catherine Thieblemont.
A treatment costing 300,000 euros
However, this sophisticated treatment requires a complex manufacturing process. And it comes at a cost. On the one hand, the undesirable effects Severe, which can lead to intensive care, are not rare, even if doctors are controlling them better and better. On the other hand, the prices set by manufacturers are excessive. In Europe, an administration of CAR-T costs more than 300,000 euros; in the United States, $450,000.
Nurses Alison De Almeida and Liwa Ta check the patient’s identity and all documents before the CAR-T cell injection. At Saint-Louis hospital, in Paris, April 15, 2024. JULIE BALAGUÉ FOR “LE MONDE” A syringe before the injection. At Saint-Louis hospital, in Paris, April 15, 2024. JULIE BALAGUÉ FOR “LE MONDE”
Before returning to Saint-Louis hospital, let’s take a quick trip across the Atlantic. By means of a videoconference, here we are with Michel Sadelain, the main architect of the genetic construction which metamorphoses T cells into tumor terminators. It was at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, a renowned cancer treatment and research center, that this French and Canadian immunologist designed and demonstrated the therapeutic power of this approach.
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