Papers of the Week

Relief of cancer-related pain remains challenging despite the availability of a range of opioid and non-opioid medications. Animal models demonstrate that T lymphocytes may mediate analgesia by producing endogenous opioids, but definitive clinical data are limited. Adoptive transfer of ex vivo activated T cell products (ACT) is being tested as an anti-cancer therapy. We retrospectively reviewed the medical charts of 357 patients with various malignancies who received three intravenous infusions of autologous cytokine-activated T cell-enriched products. Among these were fifty-five (55) patients who required opioids for moderate or severe cancer-related pain. Opioid dosage and cancer pain score were recorded daily for 2 consecutive weeks prior to and 2 weeks after the ACT infusions. The average oral morphine equivalent doses (OMED) and cancer pain scores were significantly decreased following the ACT infusions. The proportion of patients with breakthrough pain also declined. Moreover, higher frequencies of expanded CD3+, CD3+/CD4+, and CD3+/CD8+ T cells within the ACT product were associated with favorable analgesic effects. Transient elevations in CD3+ and CD3+/CD8+ T cell subpopulations and decreases in CD4CD25 Treg were observed in patients' blood after the ACT. In conclusion, ACT was capable of reducing cancer pain severity and opioid consumption and favorably modulating peripheral blood T cell populations.