Unique treatment for lymph node cancer being tested in Uppsala
From left: Researchers Magnus Essand, Gunilla Enblad and Di Yu outside the Rudbeck Laboratory. This is where the cancer treatment now being tested on patients was developed. Photo: Mikael Wallerstedt, Uppsala University
A completely new treatment for lymph node cancer is currently being tested at Uppsala University Hospital, with promising results. The cancer is fought by strengthening the patient’s own immune cells. Researchers at Uppsala University have taken the method all the way from the laboratory bench to clinical trial.
Since its introduction in November 2024, several patients have been treated and the very first patient is now cancer-free, meaning that there are no signs of cancer. Gunilla Enblad, Professor at the Department of Immunology, Genetics and Pathology, is responsible for the patient study.
“It is still too early in the development process, but this is certainly a fantastic treatment method. CAR-T cells are actually the patient’s own immune defence cells, T cells. We extract them from the body via the blood and send them to a laboratory. There, they are genetically modified so that they can attack cancer cells, in our case lymphoma, which has been the most successful by far.”
The T cells are modified using what is known as a viral vector, which can be constructed in various ways. In this case, researchers Magnus Essand and Di Yu have created their own design that is immunologically enhanced.
“We've taken it all the way from the lab bench to clinical trial. There aren’t many places in the world that do that. CART-T therapy is being trialled in this way in the USA, China and a few places in Europe,” says Gunilla Enblad.
Early adopters of CAR-T therapy
One of the reasons why researchers at Uppsala University have been so successful in this area is that they were early adopters of CAR-T cell research as a treatment for cancer.
“We started back in 2014 in collaboration with Baylor College of Medicine in Houston. CAR-T cells were developed in several different places in the USA. My research colleague Angelica Loskog was asked if we wanted to use a viral vector in Sweden,” says Gunilla Enblad.
Two different studies were conducted with 39 patients who were treated, and some people were cured. However, this particular viral vector did not have as strong an effect as other treatments that were developed in parallel and purchased by pharmaceutical companies.
“We still use these treatments, but they are not suitable for everyone for various reasons. That’s where our latest study comes in,” says Gunilla Enblad.
Strengthens immune cells
Several years ago, Magnus Essand and Di Yu discovered the protein NAP, or Neutrophil Activating Protein, which can be used to strengthen immune cells. They came up with the idea of combining the protein with a viral vector against cancer. They then developed the concept further in the lab until it was safe enough.
Gunilla Enblad and her colleagues were then brought in to design a study in which the treatment could be tested on patients. After approval by the Swedish Medical Products Agency and the Ethical Review Board, the first human trials began in November 2024. Gunilla Enblad expects the study to be completed in a year.
“Six patients have been treated thus far, and we will treat twelve more patients with gradually increasing doses. Karolinska Institutet has now also joined the study.”
Selected patients
As the principal investigator, Gunilla Enblad has helped to write the trial protocol and select which patients will receive the treatment. These are patients who have no curative treatment available and for whom this treatment method offers new hope.
“It has gone well so far. In addition to seeing good results for our first patient, things have gone well for a few others and there have been very few side effects.”
As the principal investigator, Gunilla Enblad has helped to select which patients will receive the treatment. Photo: Mikael Wallerstedt, Uppsala universitet
Uppsala has a special centre for advanced therapies, ATMP, which supports highly specialised cell and gene therapy. This usually involves “one therapy, one patient”. As in this case, where the cells are produced by the patient themselves, for the patient themselves.
It is a therapy with extremely close ties to research, and is the result of collaboration between the University and the hospital.
“We talk to each other all the time and know each other well. We follow GCP, Good Clinical Practice, for studies. An important part of the study is the Clinical Research and Development Unit (KFUE), our trial unit with experienced research nurses. They document results, side effects and such – so we work closely together,” explains Gunilla Enblad.
Can be further developed
And this may be how the new cancer therapy has come so far – through good collaboration. What remains to be seen now is what happens next with the treatment method. If the results are good, it may be possible to further develop the method through a company run by Magnus Essand and Di Yu. Only time will tell.
“That’s what we want at the ATMP Centre – for the research conducted at Uppsala University to be tested at Uppsala University Hospital, through our collaboration. It's really exciting and fun,” says Gunilla Enblad.
Annica Hulth
Pioneer in CAR-T therapy
- In 2014, Uppsala University and Uppsala University Hospital became the first in Europe to treat cancer patients with (CAR)-T cells, which is an immunotherapy in which the patient’s own T cells are equipped with a CAR molecule that recognises an antigen on the surface of the tumour cell.
- The treatment involves the patient giving a large blood sample, from which T cells are isolated and modified with a viral vector that carries the CAR molecule. The cells are then returned to the patient.
- It was Angelica Loskog’s and Gunilla Enblad’s research groups – working in collaboration with Baylor College of Medicine in Houston, Texas, USA – who pioneered this. Magnus Essand’s research group has also been instrumental in advancing the therapy.