Autoimmune Disease Treatment: Cancer Drug Success

A cell therapy that originally came from cancer medicine has now slowed the progression of the disease in a patient with a rare autoimmune disease.

After 10 years of abdominal pain, inflammation and constant restrictions, a patient’s quality of life is returning for the first time. A new type of cell therapy brought a rare autoimmune disease to a halt, against which current treatments had recently had little effect.

The treatment took place at the University Hospital Magdeburg. There, an interdisciplinary team decided to take an unusual step. Instead of further expanding the existing therapy, the doctors chose an approach that has so far been known primarily from cancer medicine.

When proven therapies reach their limits

The patient suffered from an IgG4-associated disease. This rare autoimmune disorder can affect multiple organs at the same time. The immune system attacks the body’s own tissue. Inflammation occurs, tissue hardens, and scars form. The function of affected organs declines over time. In this case, the bile ducts, lungs, pancreas and large vessels in the abdomen were affected, among other things.

For many years, doctors tried to slow down the progression of the disease with established therapies. The inflammation was temporarily contained, but did not disappear completely. The disease continued to progress. For the patient, this meant everyday life with pain, limited resilience and increasing dependence on medical care.

Why cell therapy approaches autoimmune diseases differently

When it became clear that current treatments were no longer effective, the team looked for alternatives. The decision for CAR T-cell therapy was made together with the patient. This procedure has so far been used primarily for certain types of cancer. For autoimmune diseases it is still considered experimental.

For the therapy, doctors take the patient’s own immune cells. These cells are specifically modified in the laboratory. They can then recognize and switch off disease-causing immune cells. They then return to the body. Experts speak of a “living drug” because the therapy actively works in the body and is not administered like a classic drug.

Measurable success instead of subjective impressions

A year after treatment, a stable result is seen. There are no longer any active signs of inflammation. Permanent suppression of the immune system is not necessary. The patient’s resilience has increased significantly. Longer trips that were impossible for a long time are now part of everyday life again.

The success of the therapy could also be objectively proven. Modern imaging techniques made the decline in inflammatory activity visible. “The success of the therapy could be clearly understood not only clinically but also through imaging,” says Prof. Dr. Michael C. Kreissl.

Why the case is receiving international attention

“Such a course is extraordinary in this difficult-to-treat situation,” says the treating doctor, Prof. Verena Keitel-Anselmino. In their opinion, this stability could not have been achieved with conventional therapies.

Internationally, there are only very few comparable reports. In addition to the case from Magdeburg, there is only one other documented use of this form of therapy for an IgG4-associated disease from China. Larger clinical studies are still missing.

What still remains open

It is currently unclear whether, how and for which patients this therapy can be usefully used in the future. Possible risks, long-term consequences and the duration of the effect also need to be further investigated. The published case provides important information, but does not replace systematic testing in studies.

Added to this is the organizational effort. CAR T-cell therapies are technically demanding and cost-intensive. They require specialized centers and experienced teams. So far they have been used primarily for certain types of cancer. Whether they become established in everyday autoimmune medicine remains an open question.

Collaboration as a crucial factor

For Prof. Dimitrios Mougiakakos, who also took part, one point is in the foreground. “This case shows what is possible when different disciplines work closely together,” he says. In Magdeburg, experts from hematology, gastroenterology, nuclear medicine, radiology, pathology and pulmonology pooled their experience.

The patient benefits from this approach today. For other affected people, the case provides valuable clues – and a realistic assessment of what modern medicine can achieve and where it still needs to find answers.

Briefly summarized:

• A patient with a rare IgG4-associated autoimmune disease became permanently symptom-free for the first time after suffering for more than ten years using a cell therapy originally developed for cancer after conventional treatments failed.
• The treatment at Magdeburg University Hospital made targeted use of the body’s own immune cells, the success of which was not only noticeable but also objectively verifiable using modern imaging.
• The case shows great medical potential, but at the same time makes it clear that it is still unclear whether, how and for which patients this therapy can be used in the future, as there is a lack of reliable studies and long-term data.