Overcoming Liver Cancer: Exploring The Potential of CAR-T Cell Therapy

Hepatocellular carcinoma (HCC) is the most common type of liver cancer, accounting for more than 90% of liver cancer cases. While up to 70% of HCC patients experience recurrence after first-line treatment, new and more effective therapeutic approaches are continually being researched to improve patient outcomes.

For advanced HCC, systemic therapies, such as immunotherapy, targeted therapy and chemotherapy, remain the main methods of treatment. These treatments can help manage the disease and extend survival, and researchers are continuing to improve how and when they are used to maximize their benefit.

One novel area of development is chimeric antigen receptor (CAR) T cell therapy, which trains the immune system to identify and remove liver cancer cells. Though still being evaluated in clinical trials and currently available only at select research centers, this innovative approach may expand future treatment options, especially for patients with limited alternatives.

A lesser-known fact about cancer is that it develops, in part, because cancer cells evade the immune system’s defenses. CAR-T cell therapy fights cancer by using the patient’s own immune system. Doctors first extract T cells—the key immune defenders—from the blood and genetically modify them to recognize and attack cancer cells. After engineering these cells to target specific proteins on cancer cells, they return the modified cells to the patient. In the body, these cells locate and destroy cancerous cells with great precision.

Although CAR-T cell therapy has shown success in the treatment of blood cancers, it faces significant challenges with solid tumors like HCC. Unlike blood cancers, these engineered T cells have difficulty penetrating solid tumors due to dense tissue and immune-suppressing signals. T cells must navigate through complex body pathways before reaching the tumor. Once there, they are met with the hostile tumor microenvironment that hinders their effectiveness.

Safety concerns also complicate the application of CAR-T cell therapy. Some patients experience high fevers, low blood pressure, severe swelling or organ failure as the T cells attack cancer cells. These reactions are part of cytokine release syndrome (CRS) where the immune system becomes hyperactive, harming healthy tissues in the process. There is also a risk of brain toxicity.

Additionally, CAR-T cell therapy is costly and not yet accessible to most patients.

Though still in its early stages, research in CAR-T cell therapy for HCC is advancing. One significant area of improvement is the design of CAR-T cells. Scientists are developing next-generation CAR-T cells that can withstand the hostile tumor microenvironment of HCC. These advanced designs aim to boost T cells’ survival and functionality, improving their ability to target cancer cells effectively.

Scientists are also trying to combine CAR-T cell therapy with other treatments, such as checkpoint inhibitors or chemotherapy. These strategies could potentially overcome the tumor’s defenses and enhance the overall effectiveness of the treatments.

Numerous clinical trials are exploring the potential of CAR-T cell therapy for HCC. If you are interested, you can find detailed information about these trials here.

Although it has not yet been proven effective, ongoing research and innovation may help establish this treatment as a more viable and accessible option for liver cancer patients in the future.