Aragón will finally have an Advanced Cellular Therapies Unit in 2025

The new coordinator of this Unit is Julián Pardo, a scientist at the Aragón Health Research Institute (IIS Aragón) and the University of Zaragoza, together with Aspanoa and other researchers.

After years of demands, Aragón will finally have an Advanced Cellular Therapies Unit in 2025. This new service will be used to produce and apply in the future new CART cell immunotherapies, that is, the most innovative treatments in the fight against cancer and other diseases when traditional therapies, such as chemotherapy, have failed or have been insufficient. Currently, all Aragonese patients who require these treatments have to be referred to hospitals in other autonomous communities.

Julian Pardo is the new coordinator of this Unit. This scientist from the Aragon Health Research Institute (IIS Aragón) and the University of Zaragoza, together with Aspanoa and other researchers, had been demanding that the Government of Aragon create this service since 2018. Everything was negative until last year when a particular person, Clementa Soria, left an inheritance of 1,9 million euros to the AECC. The momentum of Aspanoa and this very important legacy will ensure that Aragón will finally have this Unit.

Doctor Pardo, Aragón will be one of the last communities to have Advanced Therapies. Why did it cost so much?

Since 2018, together with Aspanoa, we started talking with the Ministries of Health and Science. We told them that immunotherapy with CART cells was a revolution and that it would be needed for more and more diseases, for which it was necessary to have a center where they could be produced. But they didn't see it that way. They said it was better to refer patients to reference hospitals in other autonomous communities. However, now there are 30 accredited hospitals throughout Spain and none are Aragonese. And they have realized that we are the only ones along with La Rioja, Extremadura and Castilla La Mancha. Fortunately, the financing of Aspanoa and the legacy of Clementa Soria through the AECC will provide a solution.

Aspanoa launched the first research against childhood cancer in the history of Aragon in 2018. It was an investment of 200.000 euros through its group and one of its objectives was precisely to bring these new treatments.

Yes. Without the help of Aspanoa it would be impossible for us to be at this point. Aragón had never investigated childhood cancer and with this project the foundations were laid so that in our Community we could apply the new immunotherapies once the regional Government created the necessary infrastructure.

The project is about to end. What discoveries or advances have been obtained?

The first part of the project consisted of studying the NK cells of children with leukemia or neuroblastoma. We all have these cells, which are also called natural killers, in the body and they are responsible for destroying tumors. So the project was to find out why these children's NK had stopped working. And to see if by modifying the patient's cells in the laboratory, or using those from a healthy relative, we could generate an effective treatment. Through blood samples, we have analyzed the NK cells of 120 children with cancer from the Miguel Servet Hospital in Zaragoza and the La Paz Hospital in Madrid. The results have been very interesting. Researchers Ariel Ramírez and Cecilia Pesini have discovered that, although NK have all the necessary weapons to destroy a neuroblastoma, they do not do so because the tumor misleads them. Specifically, NK eliminate the first cancer cells, but then the neuroblastoma forces them to secrete a protein inside them called PD1. This PD1 is an inhibitor and prevents them from continuing to attack the tumor. This discovery has been published in the prestigious journal 'Oncoimmunology' and provides us with important information, such as that if NK cell treatments are approved in the future in these patients, they will surely have to be combined with anti-PD1 drugs, which are already given to adult patients. .

Another leg of this project was the early diagnosis of aspergillus, a project by Eva Gálvez, from the CSIC.

Aspergillus is an airborne fungus that our body eliminates naturally. But in patients who are immunocompromised, as is the case of some children with cancer, it can cause a disease called invasive aspergillosis and cause death. The problem is that current tests to detect this fungus generate false negatives, which causes them to be given medication late. Dr. Gálvez has developed a biomarker that detects this disease earlier and better. In fact, it was possible to test it with 3 girls with Servetus cancer, who had fever, did not respond to treatments and the current tests were negative for aspergillosis. With the new marker, which is already patented, it came back positive and treatment could be started. It was effective and the patients managed to overcome the infection. This project is going to be the doctoral thesis of Yurena Aguilar, a pediatric oncologist from Servet who was also awarded a scholarship by Aspanoa.

Another part of the research has been carried out by Rosa del Campo, from the Microbiology Service of Ramón y Cajal in Madrid.

We have collected 45 stool samples from patients with leukemia and neuroblastoma to study their intestinal microbiota, which is key to the proper functioning of the immune system. They are now being studied and we will analyze whether the presence or absence of certain bacteria can be related to whether the NK or chemotherapy is working better or worse. This is going to be the doctoral thesis of Alba Fernández, a pediatric oncologist who is also working at Servet thanks to a scholarship from Aspanoa.

Work on the new Unit will begin shortly. When can there be CAR-T or NK treatments in Aragón?

We will take longer. We estimate that, after all the tests to validate the unit and accredit the correct production of CART or NK cells, we could begin the first clinical trials in adults in 2026. These trials will provide the necessary experience so that the Ministry can accredit an Aragonese hospital to apply therapies already approved for care purposes. The application in children will take one or two more years, pending the Government of Aragon creating other important infrastructures, such as a larger and better equipped pediatric ICU.

They say that Aspanoa's financing is attracting a lot of talent and investments to the Community. Is that so?

Yes. Our group is a good example. The Aspanoa project has allowed us to raise more funds and initiate four other lines of research in childhood cancer. If in 2018 there were 7 scientists, now there are 18. In addition, this project allowed us to obtain a robot in 2019 for the automatic production of CART or NK. And there are at least four other research groups in Aragon that had never studied this disease and that are now, thanks to the help of Aspanoa, working on it. Without the help of the Association, all this work and what has come after it would have been impossible.

Source: Aspanoa

Image: Asier Alkorta