A New Way for the Body’s Own Cells to Fight Cancer

Duke researchers help reprogram immune cells inside the body, potentially expanding access to cancer therapies

Computer rendering of engineered AAV, a grey ball with multicolored protrusions.
Illustration depicting engineered AAV variants designed to enter T cells via the CD7 receptor, enabling precise delivery to immune cells critical for CAR-T therapy. Credit: Asokan lab.

The following is a summary of a story that originally appeared on School of Medicine.

CAR-T cell therapy has transformed treatment for certain cancers by engineering a patient’s immune cells to identify and attack the disease. But the process is complex, requiring cells to be removed, modified in a lab, and then returned to the body.

A new study that included Duke researchers offers a different approach: creating these engineered immune cells directly inside the body.

Researchers developed a two-part system that works inside the body to reprogram immune cells. One part uses a virus-like envelop to deliver gene-editing tools to make precise cuts to DNA, while the other uses a harmless engineered virus to deliver the new genetic instructions needed to turn those cells into cancer fighters.

A key challenge was ensuring the treatment reached the right cells. To solve this, the team engineered millions of variants of the harmless virus and allowed them to evolve, ultimately identifying one that could specifically enter T cells.

The approach could significantly broaden access to CAR-T therapies, which are currently limited by cost and manufacturing complexity. Researchers say it may also open the door to treating autoimmune diseases and other conditions beyond cancer.

“This is a step toward what we think of as programmable medicine,” said Aravind Asokan, professor of surgery at Duke University School of Medicine. “Instead of manufacturing cells outside the body, we can program the immune system directly.”

While the method is still being refined, the findings point to a future where complex cell therapies could be delivered more simply – turning the body itself into the site of treatment.

Read the full story on School of Medicine.