A feasibility study comparing car-t cell therapy and separate limb end perfusion therapy in the treatment of melanoma

Abstract

There are several potential advancements within cancer immunotherapy, but cells of chimeric antigen receptor-T stand out. Recently, two CAR-T cell designs targeting CD19 have been approved for use in the US and the European Union due to their promising results in the treatment of hematologic malignancies. Currently, researchers are focusing on evaluating the efficientness of CAR-T cell treatment for a variety of cancer of the solid tissues. Melanoma is caused by the malignant transformation of melanocytes. In addition to the skin, melanomas can also develop in other locations where neural crest cells migrate, such as the digestive system or the brain. Melanocytes are formed in the neural crest. Since transformed cells must overcome extra obstacles to survive, the treatment of solid cancers with cells that produce CAR-T has been less successful than the treatment of hematologic malignancies with cells that produce CAR-T. A solid cancer's immunosuppressive microenvironment and the inability to migrate cells that produce CAR-T to the site of the cancer are two significant barriers. In addition, finding the optimal target antigens to avoid on-target toxicity and non-cancer toxicity is a challenge. To lessen the harmful effects of systemic chemotherapy, Creech & Krementz developed isolated limb perfusion in 1956 to create high levels of chemotherapy in limbs affected by unresectable cancers, particularly soft tissue sarcomas and melanomas. By using these targets, it is possible to remove the wounded limb's circulation from the body's circulation and connect it to an extracorporeal system. When the patient becomes excessively hot, chemotherapeutic medications, primarily melphalan & cancer necrosis factor, are administered via a perfusion circuit. The objective of this article is to provide a summary of the benefits and drawbacks of employing car-t-cell therapy to cure solid cancers, particularly melanoma. It also investigates the possibilities of curing melanoma using car-T treatment as well as isolated limb perfusion.