What are CAR-T cells & are they regenerative medicine?

The first time I heard CAR-T cells referred to as a regenerative medicine it made me stop and think. Are CAR-T therapies really a type of regenerative medicine?

Generally, CAR-T cells are a designer immune cell therapy. They work by killing cancer cells and that’s what came to mind to me. I don’t tend to think of killing off cancer as a regenerative therapy. However, some researchers and even the FDA seem to consider CAR-T cells as a regenerative medicine.

More on the FDA part in a minute.

CAR-T cells, regenerative medicine
Are CAR-T cells a type of regenerative medicine? Results of a Twitter poll.

Definition of regenerative medicine, including killing cells?

Let’s start by talking about regenerative medicine.

Regenerative medicine is generally defined as a cell or gene therapy. It restores or regenerates diseased or damaged tissues. Some chemical drugs may fit in here too.

Can killing undesired cells be regenerative? Probably, but at first look it may seem counterintuitive.

The undesired cells to be nuked don’t even have to be cancerous. In fact, some researchers are studying removing fibrotic cells from the heart via CAR-T cells.

Others are exploring using CAR-T cells to remove senescent cells from the body. Senescent cells aren’t just static but sometimes actively harm other cells and tissues. An effective CAR-T therapy that kills senescent cells could reverse some of the ill effects of aging.

FDA view of CAR-T cells

The FDA started a new program a few years back called Regenerative Medicine Advanced Therapy designations or RMATs. Biotechs or other sponsors who have products that qualify as an RMAT get various advantages that speed up the pipeline. Notably, the RMAT program includes many experimental CAR-T cell therapies that are in trials.

You can see my list of active RMATs.

Therefore, it seems that the FDA views CAR-T cells as a regenerative medicine. Most respondents in a recent poll saw things differently though.

I wonder what other creative ideas may leverage this kind of designer T-cell technology moving forward.

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