Cellular immunotherapy is one of the most advanced anti-tumor cellular immunotherapy approaches available. In recent years, several countries have carried out cellular immunotherapy and have acted clinically. In addition, Japan, the United States, Germany and other countries with leading medical standards have made breakthroughs in immune cell therapy for cancer.

So is pancreatic cancer, the king of cancers, amenable to cellular immunotherapy?

Pancreatic cancer treatment has always been a clinical challenge. Due to the special microenvironment, it is difficult for drugs to enter, not to mention that pancreatic cancer cells can modify the stroma around the tumor, forming a "brick wall" that prevents drug penetration, making it difficult for chemotherapy drugs to kill the cancer cells inside the tumor.

In addition, they exhibit an immunologically "cold" tumor microenvironment (TME) characterized by a prominent myeloid infiltrate, usually lacking CD8+ T cells (T effector) and low expression of activation markers (e.g., GZMB and IFNG), which are hallmarks of adaptive T cell immune deficiency or dysfunction. It is the specific immune environment of pancreatic cancer itself that allows abnormal biological activity of T cells, immune escape of tumor cells, and abnormal immune checkpoints to occur.

However, with the development of medical technology, this problem has been gradually solved, and we know that the immune system is not only involved in the body's defense against pathogenic invasion, but also in the removal of its own abnormal cells and related products. Immune cells in the body recognize substances other than normal cells (e.g., antigens, cancer cells, viruses), which in turn trigger an immune response and initiate an immune attack to remove the pathogen.

By means of cell engineering and genetic engineering techniques, scientists have been able to alter several abilities of immune cells for cancer treatment, including: the ability of immune cells to recognize cancer cells, the ability of immune cells to kill cancer cells, and the removal of cancer cells' inhibition of immune cells. Because the immune T cells used to treat cancer have memory and can be expanded, patients using this therapy gain the ability to kill the cancer cells in the tumor over time.

Patients with pancreatic cancer stabilized for more than 2 years with a combination of chemotherapy and DC+NKT cell therapy

He was diagnosed with pancreatic head cancer (stage 4b) that had metastasized to the lungs. Due to the metastasis and the fact that Mr. Chen is a diabetic, he was evaluated by the doctor and decided that he could not undergo surgery.

At the end of the treatment, the tumor appeared to be slightly reduced by enhanced CT examination. However, in the subsequent treatment, Mr. Chen's tumor progressed because the side effects of chemotherapy were so strong that he needed to reduce the dose of drug administration.

The adjuvant use of chemotherapy coupled with the severe pain caused by cancer made Mr. Chen's body incredibly weak, and he even considered giving up the treatment at one point.

Afterwards, with the introduction of a patient, Mr. Chen learned about cellular immunotherapy. After the affirmation of the treating doctor and the interview with the cellular immunologist, Mr. Chen started a new round of treatment.

Based on the results of the immune status test (immune function test) and cancer cell marker test (immunohistochemical staining test), the specialist formulated a combination of immune cell therapy (DC+NKT) + chemotherapy (gemcitabine) + radiotherapy, during the treatment period, the immune cell therapy did not have any side effects, and the symptoms of leukopenia and diarrhea, which often occurred during chemotherapy, did not appear.

After two courses of complex immune cell therapy already chemotherapy, Mr. Chen's CA19-19 gradually decreased, and in the CT examinations he received regularly, there was no progression of pancreatic cancer and the lung cancer lesions were significantly reduced.

Later, after the doctor's assessment and decision, considering that Mr. Chen's physical condition had recovered to a normal level, plus the pancreatic lesions had shrunk significantly, he was given another 8 stages of chemotherapy in order to enhance the efficacy of chemotherapy, during which Mr. Chen's physical condition was maintained, followed by a two-year-long follow-up, during which Mr. Chen's physical condition was unchanged and he was able to live normally.

The emergence of cellular immunotherapy has brought hope to many pancreatic cancer patients, not only compensating for the lack of pancreatic cancer treatment, curbing the development of cancer cells to a higher degree, improving the 5-year survival rate of pancreatic cancer patients after surgery, but also allowing more inoperable pancreatic cancer patients to successfully achieve tumor down-staging, thus removing the lesion and prolonging the survival of patients.

In addition, Japan, the United States, Germany and other leading medical countries have made breakthroughs in immune cell therapy for cancer. As the pioneer of cellular immunotherapy, Japan, with the development of next-generation sequencing and bioinformatics technology, its technology has evolved from the original cancer antigen peptide cell therapy to HLA paired cancer antigen peptide cell therapy to de novo antigen peptide vaccine.

Compared to previous tumor antigens, new antigens with high immunogenicity and tumor specificity provide new targets for individualized immunotherapy of tumors, giving the returned immune cells the ability to persist and generate post-treatment immune memory, which holds the promise of long-term prevention of disease recurrence.

Combined with conventional treatment, the tumor can be downgraded to achieve surgical resection: cellular immunotherapy is to treat tumors by infusing tumor patients with immune cells that have anti-tumor activity after being amplified or activated in vitro in culture, which directly kill or stimulate the body's immune response to kill tumor cells. Therefore, some pancreatic cancer patients can be treated by combined cellular immunotherapy, which can not only kill cancer cells in the body, but also reduce the side effects brought by radiotherapy and achieve surgical resection.

Post-operative identification to remove hidden cancer cells and reduce the probability of recurrence: The immune cells transfused back have an important immune surveillance function due to their natural ability to kill tumors inherent immune cells. In the process of recognizing and killing tumor cells, they will generate "memory" and repeat the process of "recognizing and killing tumor cells" continuously, providing long-term anti-tumor protection for patients.

Note: Cellular immunotherapy requires the addition of chimeric antigen receptors to the extracted immune cells, so the exact protocol will need to be tested and evaluated by a professional physician before a decision can be made.

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