Longevity
CAR T-cell therapy is curing some blood cancers. Here is where oncology stands now.
By Life and Health Today Staff, . Life and Health Today.
Genetically engineered immune cells are keeping some leukemia and lymphoma patients alive fifteen or twenty years after a diagnosis that once had no good answer. That is one of the clearest advances oncologist Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies, described in a recent conversation on The Peter Attia Drive podcast.
What CAR T-cell therapy actually is
CAR T-cell therapy works by taking a patient's own T-cells (the immune system's attack cells), engineering them in a laboratory to recognize cancer, and returning them to the body. According to the podcast, this approach can cure certain liquid cancers, meaning blood cancers such as leukemias and lymphomas, in a meaningful share of patients. "There are people walking around on earth that have had CAR T-cell therapy for unresponsive leukemias and lymphomas who are 15 years post-therapy," Mukherjee said. He was careful to define cure not as surviving five years but as surviving fifteen or twenty.
Solid tumors, the kind that form in organs, are a different problem. The podcast notes that CAR T-cell therapy has not translated to those cancers the way it has to blood cancers, without specifying why in the portion of the transcript available.
Immunotherapy and lung cancer
Mukherjee described writing himself a personal note fifteen years ago saying he did not expect to see a medicine that could extend the life of a smoker with lung cancer. That note is now wrong. Immunotherapy, a class of drugs that strips away the molecular camouflage cancer uses to hide from the immune system, has extended survival in smokers with lung cancer when given to the right patient population, he said on the podcast.
Where the picture is more complicated
Not every trend is moving in the right direction. Breast cancer mortality had been falling year after year, Mukherjee told the podcast, and that decline has now slowed. Colorectal cancer is rising in younger adults, and the reason is not yet known. Endometrial cancer is rising too, and the podcast attributes that increase most likely to obesity. Esophageal cancer is also climbing, probably linked to alcohol and tobacco combined, though Mukherjee noted that alcohol consumption has actually been falling, which makes the timing harder to explain.
On early detection, the podcast describes blood tests that can pick up signals associated with some cancers before symptoms appear. Used broadly across the general population, those tests are likely to generate false positives and trigger imaging, biopsies, and cascades of follow-up testing without reducing cancer deaths overall, according to Mukherjee. In people who carry cancer-predisposing mutations or have a prior cancer history, the same tests may be genuinely useful.
The inflammation question
One of the more forward-looking parts of the conversation concerns inflammation as a contributor to cancer risk. Mukherjee described a "gun and trigger" model: an inflammatory state in the body acts as the gun, and specific mutations pull the trigger. The field does not yet have a blood marker that identifies a person's pro-carcinogenic inflammatory state the way a cholesterol reading identifies cardiovascular risk. He expects researchers will eventually find one, and that it will open the door to prevention trials.
Metabolic factors, including hyperinsulinemia (chronically elevated insulin levels), also came up as an area of active interest. The podcast notes that clinical trials targeting cancer metabolism are underway, though it does not describe results from any of them in the portion available.
What this conversation is and is not
This is a podcast episode, not a published study. Mukherjee is a credentialed oncologist and researcher at Columbia University, and the claims he makes track with published science, but the conversation has not been peer-reviewed and the full transcript was not available for this report. The advances described, particularly CAR T-cell therapy for blood cancers and immunotherapy for lung cancer, are real and established in clinical practice. The questions around inflammation biomarkers and metabolic cancer therapies are active research areas, not settled ones. Anyone weighing a cancer screening decision or a treatment option should work through it with a clinician who knows their individual history.
Source: https://peterattiamd.com/sidmukherjee3/
Life & Health Today provides information for educational purposes only, not medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.