Can a Cancer Therapy Revolutionize Treatment for Multiple Sclerosis?

A groundbreaking approach that has shown promise in fighting cancer is now being explored as a potential game-changer for people with multiple sclerosis

The Story of Grace Miller

Grace Miller, a 46-year-old from Fishers, Indiana, was diagnosed with multiple sclerosis at the age of 24. For years prior to her diagnosis, she had experienced severe fatigue, which was initially suspected to be caused by narcolepsy. However, when she began to experience bouts of vertigo and temporary vision loss, her doctor determined that she had multiple sclerosis. Miller spent 15 years on two different medications that made her feel sick every time she got a new dose. Her vision has faded in and out over the years, and in 2021, she started walking with a cane. "I used to work as a lawyer, but reading a book is not even an option anymore," she said.

The Potential of CAR-T Therapy

Miller enrolled in an early-stage clinical trial at the Cleveland Clinic for a cancer therapy called CAR-T therapy, which researchers hope could halt the progression of multiple sclerosis. CAR-T therapy involves extracting a person's own T cells, reprogramming them to identify and attack proteins found on tumor cells, and then infusing them back into the body. This treatment has been particularly effective against cancers that affect B cells, such as leukemia and lymphoma. Rogue B cells also play a major role in multiple sclerosis, becoming overactive and attacking the myelin that protects and insulates nerve fibers in the central nervous system.

How CAR-T Therapy Could Target Multiple Sclerosis

According to Dr. Jeffrey Cohen, director of the experimental therapeutics program at the Cleveland Clinic's Mellen Center for Multiple Sclerosis, CAR-T therapy may be able to target the same overactive B cells that current multiple sclerosis drugs already do. The key difference is that CAR-T cells appear to be able to reach B cells in the brain and central nervous system, which current drugs cannot. "Not only would they kill B cells in the blood, like our already approved antibody therapies do, but also the ones that are hiding in the brain, which we think play an important part in progression," Dr. Cohen said. Inflammation caused by dysregulated B cells in the brain and central nervous system makes MS symptoms worse.

Ongoing Clinical Trials

Similar trials are underway across the country, including ones at Stanford University, Mass General, and Columbia University. The Cleveland Clinic trial, sponsored by Bristol Myers Squibb, has recruited four people with MS, as well as three people with another autoimmune disease called myasthenia gravis. Two of the people with MS, including Miller, have progressive MS, while the other two have relapsing MS. While the results of these trials are still unclear, the fact that there is already extensive experience with CAR-T therapy in cancer gives researchers a head start. As Dr. Cohen emphasized, all CAR-T trials for MS are very early exploratory studies, and it is still unclear whether the treatment will be successful.

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