Hello,

We noticed you're browsing in private or incognito mode.

To continue reading this article, please exit incognito mode or log in.

Not a subscriber? Subscribe now for unlimited access to online articles.

Rewriting Life

A Cure for a Childhood Cancer—but Will It Last?

Modifying a child’s immune system to fight off leukemia can yield dramatic results, but the treatments are dangerous and no one knows if they’re permanent.

The first time a child gets acute lymphoblastic leukemia it’s worrying, as any cancer would be, but generally curable. If it comes back, a bone marrow transplant could still wipe it out. If it comes back again, it is often a death sentence.

Or at least it was, until an experimental treatment that genetically enhances a patient’s immune system, known as CAR-T, came along. Only tested in humans in the last few years, the results have been astonishing, knocking out almost overnight a cancer that defied all other treatments. Early tests showed that 90 percent of patients went into remission.

There are, unfortunately, two major problems with CAR-T therapy. First, it is dangerous—deaths are not uncommon in clinical trials involving CAR-T. But for many patients the risk of a fatal reaction to the treatment is an acceptable one, given the potential benefit.

The second principal concern is that the cancer will come back. As a heartrending story in the Washington Post describes, by the time children enter into a CAR-T trial they (as well as the families that support them) have already been through hell. In the case of eight-year old Ava Christianson, the focus of the Post’s piece, the cancer survived even a round of CAR-T treatment, in which Ava’s immune cells were harvested from her, genetically modified, and given back to her. She was in for another, newer generation of the treatment, and it appeared to be working.

“We just need this to work and stay working for her,” her mom, Bethany Christianson, told the Post as she held back tears.

That’s the thing about CAR-T. Powerful as it is, it is such a new therapy that no one knows whether the effects are permanent—and if they aren’t, how long they last. Last year, we followed the story of one patient, Milton Wright III, who at 18 months had been one of the treatment’s longest survivors.

The phrase “a cure for cancer” has been around so long, it’s become cliché—a term invoked figuratively to describe a great achievement, or a panacea. As we approach such a cure, however, the reality is turning out to be far more fragile.

(Read more: The Washington Post, “10 Breakthrough Technologies 2016: Immune Engineering,” “Biotech’s Coming Cancer Cure”)

Blockchain is changing how the world does business, whether you’re ready or not. Learn from the experts at Business of Blockchain 2019.

Register now
More from Rewriting Life

Reprogramming our bodies to make us healthier.

Want more award-winning journalism? Subscribe to MIT Technology Review.
  • Print + All Access Digital {! insider.prices.print_digital !}* Best Value

    {! insider.display.menuOptionsLabel !}

    The best of MIT Technology Review in print and online, plus unlimited access to our online archive, an ad-free web experience, discounts to MIT Technology Review events, and The Download delivered to your email in-box each weekday.

    See details+

    12-month subscription

    Unlimited access to all our daily online news and feature stories

    6 bi-monthly issues of print + digital magazine

    10% discount to MIT Technology Review events

    Access to entire PDF magazine archive dating back to 1899

    Ad-free website experience

    The Download: newsletter delivered daily

  • All Access Digital {! insider.prices.digital !}*

    {! insider.display.menuOptionsLabel !}

    The digital magazine, plus unlimited site access, our online archive, and The Download delivered to your email in-box each weekday.

    See details+

    12-month subscription

    Unlimited access to all our daily online news and feature stories

    Digital magazine (6 bi-monthly issues)

    Access to entire PDF magazine archive dating back to 1899

    The Download: newsletter delivered daily

  • Print Subscription {! insider.prices.print_only !}*

    {! insider.display.menuOptionsLabel !}

    Six print issues per year plus The Download delivered to your email in-box each weekday.

    See details+

    12-month subscription

    Print magazine (6 bi-monthly issues)

    The Download: newsletter delivered daily

/3
You've read of three free articles this month. for unlimited online access. You've read of three free articles this month. for unlimited online access. This is your last free article this month. for unlimited online access. You've read all your free articles this month. for unlimited online access. You've read of three free articles this month. for more, or for unlimited online access. for two more free articles, or for unlimited online access.