Medical breakthroughs come with a human cost

Medical innovations can be risky, as this issue’s cover story on new CAR-T cell therapies for cancer reveals. The treatments, which tailor a patient’s own immune system cells to attack cancer, can be astonishingly successful. But CAR-T therapy can also be an untamed beast, unleashing a ferocious immune response that indiscriminately attacks the body. The challenge scientists face now is how to tame the therapy while retaining its cancer-killing powers.

It’s hardly the first medical advance to pose risks in its early days. Organ transplants are one of the most famous examples. In the 1960s, before the adoption of immune-suppressing drugs, fewer than 1 in 3 people were alive a year after a liver transplant (SN: 3/3/18, p. 4). The early days of open-heart surgery were also frightening. I’ve never forgotten interviewing pioneering Cleveland Clinic heart surgeon Delos “Toby” Cosgrove, who told me that when he first started performing the surgeries back in the 1970s, “half of my patients went home in a box.” He wasn’t being flippant; years later, those deaths still weighed on him.

Like those early heart surgery and transplant patients, people willing to try CAR-T therapies have exhausted their options. As reporter Laurel Hamers writes, scientists are trying to reengineer the treatments so they’re safer. Paul Martin, a pediatric oncologist at Duke University, told her: “Immunotherapy goes back a long time, but successful immunotherapy is just in its infancy.”

Medical innovation is truly a partnership that involves patients, researchers and clinicians. If CAR-T therapy turns out to be a winner, the treatment will join other notable advances, including antibiotics, insulin and chemotherapy. Fortunately, not every advance comes at a high human cost. When “test-tube babies” debuted in July 1978, there was widespread fear that the children would be plagued with mental or physical defects (SN: 12/9/78, p. 407). Those fears proved unfounded, with millions of healthy IVF babies born since then.

We’ll continue to cover the successes and failures of biomedical innovation, and as always, provide the long view.

Nancy Shute is editor in chief of Science News Media Group. Previously, she was an editor at NPR and US News & World Report, and a contributor to National Geographic and Scientific American. She is a past president of the National Association of Science Writers.

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