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.