China Medical University Hospital (CMUH) constantly pursues innovation and breakthrough. On May 15, 2019, CMUH was approved by the Ministry of Health and Welfare to use dendritic cell (DC) therapy to target “stage IV solid tumors”. The use of autologous bone marrow mesenchymal stem cells (BMSC) for “stroke” and “arthritis” and dendritic cell therapy for “stage I-III solid tumors unresponsive to standard therapy” were also proposed to the Ministry of Health and Welfare for review. In order to make movements in the realm of cell therapy, CMUH “Translational Cell Therapy Center” will hold its grand opening on June 18 and the center will receive and treat patients with 8 types of stage IV solid tumors, including Glioblastoma Multiforme (GBM) and secondary brain tumors (metastatic brain tumors), epithelial ovarian tumors, pancreatic cancer, prostate cancer, head and neck cancers, liver cancer, breast cancer, and colorectal cancers. In the future, the center will expand the scope of its treatment to include stroke and arthritis once the cell therapy proposals have been approved by the Ministry of Health and Welfare, thereby benefiting more patients. 

CMUH has conducted research in cell therapy for more than 10 years. Apart from establishing the GTP Core Cell Laboratory in conformity with the Regulations on Human Cell Therapy Clinical Trial, CMUH cooperated with Ever Supreme Bio Technology Co., Ltd. to apply for the use of cell therapy to treat 8 types of cancers, all of which were approved by the Ministry of Health and Welfare since there were patients in Taiwan and overseas meeting the prerequisites for treatment and already asking about the therapy process. In the past, many patients had to travel overseas to Japan and U.S. to receive cell therapy for their diseases, but there were always some concerns over their safety and patient rights. The Ministry of Health and Welfare made revisions to the “Regulations Governing the Application of Specific Medical Examination Technique and Medical Device” (known as Specific Application Regulations) last September 6, allowing approved medical institutions to legally treat certain diseases with cell therapy. Sick patients no longer have to risk their lives and travel overseas to seek medical treatment due to the opening of this new regulation, which unquestionably is an amendment in favor of the medical rights of patients. 

A new dawn and a new hope for cancer therapy
The prognosis for stage IV cancer is very poor and the options for medical therapy are highly limited. Hence, the entire world is attempting to develop new therapies and dendritic cell therapy is gaining popularity, currently generating about 5,000 academic papers. It is proven in laboratory testing that tumor antigens or vaccines prepared with dendritic cells are highly effective in inhibiting and treating cancer. Furthermore, according to treatment experiences in Europe, U.S. and Japan, patients receiving dendritic cell therapy do not have many adverse reactions or significant side effects. 

CMUH has applied for the use of dendritic cell therapy to treat 8 types of cancers, including Glioblastoma Multiforme (GBM) and secondary brain tumors (metastatic brain tumors), epithelial ovarian tumors, pancreatic cancer, prostate cancer, head and neck cancers, liver cancer, breast cancer, and colorectal cancers. Domestic and foreign studies reveal that patients with these 8 types of cancers can benefit from immunotherapy. For example, with liver cancer, domestic literature reports suggest that the 1-year and 2-year survival rates for patients with advanced stage liver cancer receiving dendritic cell immunotherapy are higher than those for patients not receiving immunotherapy. 

The formation and promotion of cancer is related to poor immune systems in patients. In the past, chemotherapy and targeted therapy treated cancer cells inside the patients’ body, but concurrently damaged the function of normal cells in the body. The autoimmune dendritic cell (DC) therapy adopted by CMUH is the 4th type of treatment for cancer, following surgical therapy, chemotherapy, and radioactive therapy. The therapy cultures tumor cell antigens outside the body using a patient’s tumor tissue, which is co-cultured with the patient’s dendritic cells in order to prepare a dendritic cell vaccine that is then injected into the patient’s lymph nodes. The vaccine has the ability to educate T cells, allowing them to identify and kill cancer cells. Dendritic cells also release toxic factors to kill cancer cells, thereby inhibiting tumor growth or tumor cell proliferation, even diminishing or wiping out tumors altogether. The side effects from receiving cell therapy are relatively less compared with traditional chemotherapy and targeted therapy because the cells come from the patient. 

Chronic ischemic stroke cell therapy improves sequelae of stroke
Chronic ischemic stroke currently does not have effective treatment and patients can only rely on long-term rehabilitation to preserve mobility as much as possible. Sequelae of strokes bring many inconveniences for patients later in life, as well as stress for families and caretakers. The research team at CMUH collects stem cells in the peripheral blood and, using computer positioning technology, injects them directly into the cerebral lesions of patients with stroke, thereby regenerating the cranial nerves and restoring function through the reparative and regenerative function of stem cells.

CMUH has achieved excellent breakthroughs in research related to stem cell therapy for strokes. The Translational Medical Research Center team uses their patented culture medium to successfully increase the growth content of “IGF1R+ mesenchymal stem cells”, which provide more therapeutic effects than “IGF1R- mesenchymal stem cells” on the brain damage caused by stroke. Such research results have been published in the internationally-renowned journal – Scientific Reports. Consequently, because of the research and development of mesenchymal stem cells, the treatment of strokes has entered a new dawn.

Degenerative joint disease cell therapy repairs joint tendons
The standard therapy for degenerative joint disease currently adopts oral painkillers or non-steroid anti-inflammatory agents to reduce pain or control inflammation. The therapy can also include glucosamine or hyaluronic acid injections into joints to increase joint lubrication. Recently, the injection of PRP paid out-of-pocket has also been on the rise. Nonetheless, these therapies only improve symptoms or functioning, but do not change the disease process or effectively mitigate the damage or aging of the joint tendons. Hence, patients still suffer from consistent abrasion on the joint tendons after therapy, the effects of which eventually disappear. The long-term administration of painkillers or anti-inflammatory agents also results in gastrointestinal bleeding and damage to liver and renal functions. 

Regenerative medicine related to cell therapy enhances the regenerative capacity of joint tendons through the transplantation of stem cells. The technology developed by CMUH currently divides each therapy session into two injections, totaling 100 million autologous bone marrow mesenchymal stem cells, which effectively alleviate the swelling and pain resulting from the injection. Moreover, the therapy has a regenerative effect by injecting stem cells into the joints. Patients receiving this type of therapy not only experience improvement in their arthritis symptoms and functioning, but also improvement in their disease progression. 

CMUH state-of-the-art cell therapy is developing at full speed
CMUH “Translational Cell Therapy Center” integrates all of the hospital's resources to lead the hospital in developing comprehensive cell therapy technology. There are 165 clinicians at CMUH who qualify for the Ministry of Health and Welfare’s designation of a professional physician of cell therapy. The approval of autoimmune dendritic cell therapy for solid tumors is just the first step for CMUH “Translational Cell Therapy Center” towards the future in state-of-the-art medical treatment. The center has also applied for the approval of autoimmune dendritic cell therapy to treat stage I-III solid tumors unresponsive to standard therapy. In the future, the center will develop cell factors of cytokine-induced killer (CIK) cells for solid tumor therapy, further expanding the types of cancers applicable for treatment and increasing the number of patients benefiting from therapy. In addition to autoimmune dendritic cell therapy, the Ministry of Health and Welfare also includes stem cell therapy for tissue repair in the approved Specific Application Regulations. As such, CMUH “Translational Cell Therapy Center” will apply to the Ministry of Health and Welfare for permission to use multiple stem cell therapy technologies to target stroke, spinal cord injury and degenerative joint diseases for the welfare of more patients in the future.

CMUH has advanced rapidly in recent years. Not only does CMUH foster many talents in critical care and medical education, but it also rivals the competition in the development of international medical technology, such as R&D of medical devices for minimally invasive surgery, AI-based medical care and 3D printing medical care. At the university commencement ceremony held on June 1, CMUH Chairman Chang-Hai Tsai encouraged all the graduates to understand the future direction of the world and find a way to become a world leader. CMUH “Translational Cell Therapy Center” officially announced its entry into the new field of cell therapy with such a promise, this also signifying the coming of Taiwan’s cell therapy era. In the future, through the “Translational Cell Therapy Center”, CMUH will link clinical needs with industrial development, integrate all aspects of the medical and technological fields, and further promote Taiwan’s state-of-the-art and innovative medical care to the world.