Carl June: 'Artificial intelligence will make Car-T accessible to all'

The idea of treating a tumour without using a drug, but with cells reprogrammed to recognise and destroy it, introduces a new way of approaching treatment. Today, cell therapies are a clinical reality in oncology, but their history has its roots in an experiment born out of pure scientific curiosity. "When we started out, it was just an academic attempt,' explains US immunologist Carl June, professor at the University of Pennsylvania, pioneer of Car-T therapies and winner of the Balzan Prize 2025, the ceremony for which will be held in Berne on 14 November, to Sole24Ore. 'We wanted to understand whether it was possible to reprogram a cell in the human body, and we discovered that the mechanism works better in people than in laboratory mice.

That initial surprise in the 1980s turned into one of the most important innovations in contemporary medicine in a few decades: the possibility of fighting leukaemias, lymphomas and myelomas through T lymphocytes (a type of white blood cell) genetically modified to recognise tumour cells and destroy them. The therapy - whose acronym is derived from Chimeric antigen receptor T cells - consists of taking lymphocytes from the patient, modifying them in the laboratory and reintroducing them into the body after equipping them with a receptor capable of identifying specific targets. It is the first cell-engineered therapy introduced into clinical practice, and is now approved in the US and Europe for seven types of cancer. The approach has changed the perspective not only of treatment, but also of research, demonstrating that synthetic biology can be safely applied.

The next goal is to bring the same efficacy to solid tumours, whose characteristics limit the effectiveness of a lymphocyte-based approach. 'We are still searching for solutions, with more than a thousand clinical trials under way worldwide to find out how to get around this obstacle,' June says. The most promising advances concern glioblastoma, the most frequent brain tumour, and neuroblastoma, the most common in children: I am confident that the problem will be solved'.

Autoimmune diseases could also soon benefit from this clinical approach, extending the potential of these therapies beyond oncology. Studies conducted in Germany show that Car-T cells developed to fight cancer can also restore the balance of the immune system in diseases such as systemic lupus erythematosus, which affects about 8% of the population in the US and Europe.

However, scientific efficacy is only part of the problem: the real challenge is to make these therapies accessible. Car-Ts require complex production, long lead times and high costs. 'It is normal that new technologies are expensive at the beginning: it happened, outside the health world, with computers and smartphones,' notes the immunologist. 'Today the most expensive part is the human labour, i.e. the people who have to learn how to produce Car-T cells. But with robotics and automation the costs will come down, we are already seeing signs in this direction'.