Leukemia, here is the Car therapy: thus helps HIV to destroy cancer cells.

The team's discovery of Professor Carl June of the University of Pennsylvania, could lead to significant advances in the treatment of cancer. In patients with acute lymphoblastic leukemia it has about 90 percent complete remissions.

The journal Science called it a "revolutionary therapy". To tell it, the cure developed by Dr. Carl June seems science fiction: it comes to serial killers that are injected into the sick patient to hunt down cancer cells, eliminating up to one thousand each. Without affecting healthy ones. And when they are not enough to fight the enemy, multiply by themselves, as if they were common antibodies, creating an anti-cancer army in the body. The results? Above all expectations. In patients with acute lymphoblastic leukemia it has about 90 percent complete remission: even years after the treatment, you do not record any sign of cancer.

The therapy is called Car (from Chimeric antigenic receptor, ie T cells with chimeric receptor) and consists of taking the linfocitiT (subgroup of white blood cells) from a leukemia patient sick and then grow them in a laboratory and reprogram them to remove the tumor. To turn them into serial killers should be the fusion of a protein and an antibody: the white blood cells are then "infected" by lentiviruses, vectors derived from HIV virus - although obviously modified so that they are not toxic - and known for their ability to penetrate the cells. This lentivirus is able to transfer pieces of DNA in the lymphocyte and arm them with the novel protein (Car fact) produced artificially in the laboratory, he can find and destroy leukemia, creating a sort of memory in the immune system. As explained by Dr. June, "the modified T cells do not interact with the cells that are not cancer, and thus limit the side effects caused by standard therapies. The tumor cells express a protein (CD19) that the modified lymphocytes are able to recognize and attack with precision. And since they have an enormous capacity to reproduce itself, they must be conceived as a serial killer army incredible killing power. "

If Professor June was able to realize this therapy - whose roots date back to the eighties - it is also about the case. Early in his career he had decided to concentrate on leukemia, specialization that had to leave during the Vietnam War, when he enlisted in the US Navy. "The US military claimed that we we were to concentrate on other fronts, such as malaria vaccines or cures for HIV." That's how June is dedicating several years to the study of this virus. "At first the professor tried to stimulate lymphocytes to recognize HIV," said Dr. Marco Ruella, Turin hematologist who since 2012 is part of the team of Carl June at the University of Pennsylvania. Then intuition: apply the same process to flush out cancer cells. But how do you put in a cell a protein that does not exist in nature? Carl June realizes that the lentivirus derived from HIV are perfect Trojan horses.

The breakthrough, which carries the signature of June, was in fact to be able to transport the new protein from the laboratory to the clinic. The professor begins trials at the end of the nineties, at UPenn, and 2010 is the first patient, a former soldier of 60 years suffering from leukemia in the terminal phase. Years have passed since Bill, the patient number one, and Emily, the first child to experience the therapy, were treated. Thanks to their healing, experiments have been going on: "We have already treated about thirty many acute and chronic leukemias leukemias. Sixty cases - explains Dr. Ruella - with unexpected results, especially considering that these people had already received therapies, or transplantation, and their prognosis was poor. There was no alternative, if not experimental treatments. In patients with acute lymphoblastic leukemia it is between about 90 percent complete remissions. Some patients have relapsed after months or years. But the majority, even years after, does not show any hint of cancer, and we are talking about people who had a life expectancy of a few months of life. For this immunotherapy it was declared a "breakthrough" (an achievement in research). Chronic leukemia is shown is more difficult to eradicate. Explain the medical faculty of the UPenn that "we were able to recover about 50 percent of patients. The factors at stake are several, but the results are much better than those of standard therapies. "

After being treated in Carl June team, the patient's blood is filtered to prelevarne white blood cells. These are then transported in special laboratories, isolated and proliferate facts. The key step is the transfer within the T lymphocytes of this new artificial protein (Car), thanks to the vector derived from HIV. After about ten days of expansion, the lymphocytes are ready to fight the tumor. Making control tests to verify that the protein is actually expressed, and serial killers are then (usually) frozen. In the meantime, the patient is undergoing chemotherapy, to lower the number of T lymphocytes present in the blood, and to make space to those modified in the laboratory. Then the process is quick and simple as a blood transfusion. "It is in 10, 15 minutes - explain the laboratory - The modified cells roam the body, come in contact with this leukemia in the blood and bone marrow and then start on the one hand to kill cancer cells and on the other to reproduce exponentially. " If the costs are so high (about 600 thousand dollars for therapy) it is because - although the virus that is used to transfer the protein in T lymphocytes is universal - these are grown individually in the laboratory: therapy based on the individual patient's white blood cells , it measures. But the pharmaceutical company Novartis - has put the therapy at the height of the priorities in its research budget, which amounts to almost $ 10 billion - already talk of proposing care at no cost in developing countries, and explains that, once entered the market as a clinical product (in 2016 in America), the price will drop still automatically. One of the most striking aspects is then that the side effects in the long run, they are very mild. When the therapy works patients - who had an expectation of life of a few months - in addition to not have more leukemia notice also the absence Lymphocytes, which produce antibodies. Then, every two or three months, receive an infusion of antibodies, however, it considered by doctors not at all prohibitive. For the rest, they have before a normal life.