‘First’ patient free of cancer: Indigenous CAR-T cell therapy brings treatment cost down from Rs 4 crore to Rs 40 lakh
- February 8, 2024
- Posted by: OptimizeIAS Team
- Category: DPN Topics
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‘First’ patient free of cancer: Indigenous CAR-T cell therapy brings treatment cost down from Rs 4 crore to Rs 40 lakh
Subject: Science and tech
Section: Health
Context:
- Dr (Col) V K Gupta has been declared cancer-free since he took the indigenously developed CAR-T cell therapy at Mumbai’s Tata Memorial Hospital.
More on news:
- The therapy is developed by ImmunoAct, IIT Bombay and Tata Memorial Hospital, the therapy has been administered to 15 patients in India.
- Months after India’s drug regulator approved the commercial use of CAR-T cell therapy, a pioneering treatment that genetically reprogrammes a patient’s immune system to fight cancer, Gupta, a Delhi-based gastroenterologist, became one of the first patients to access the therapy by paying Rs 42 lakh.
- Doctors at the Tata Memorial Hospital, where he underwent the procedure, said he is “currently free of cancer cells”, the first commercial patient to achieve that status.
About NexCAR19:
- NexCAR19 is the indigenously developed therapy that Gupta underwent, is a treatment for B-cell cancers (types of cancers that form in the immune system’s cells) such as leukemia and lymphoma.
- It has been developed collaboratively by ImmunoACT, a company incubated at the Indian Institute of Technology Bombay (IITB), IIT-B and Tata Memorial Hospital.
- The commercial use of this therapy was approved by the Central Drugs Standard Control Organisation (CDSCO) in October 2023.
- NexCAR19 is available in over 30 hospitals in more than 10 cities in India.
- Patients over the age of 15 years who suffer from B-cell cancers are eligible for this one-time therapy at these centers.
- Currently, the treatment cost is in a price range of Rs 30-40 lakh for CAR-T therapy.
- The ultimate goal is to bring the cost down to Rs 10-20 lakh.
Who can get the NexCAR19 therapy?
- The therapy is for people with B-cell lymphomas who didn’t respond to standard treatments like chemotherapy, leading to relapse or recurrence of the cancer.
- Recovery typically occurs within two weeks after one cycle of the treatment.
- In our data, approximately 70% of patients respond to the treatment, with variations between leukemia and lymphoma cases.
- About 50% of these responsive patients achieve a complete response.
About CAR-T cell therapy:
- As part of the therapy, the patient’s T-cells (types of immune cells) are collected and genetically modified into potent cancer fighters known as CAR-T cells so that they express chimeric antigen receptors (CARs) specific to cancer cells.
- The modified CAR-T cells are then expanded in the laboratory before being infused back into the patient.
- These engineered cells recognise and attack cancer cells, with a focus on B-cell cancers, thus offering a targeted and potent immunotherapy.
- CAR-T is a revolutionary therapy that modifies immune cells, specifically T-cells, by turning them into potent cancer fighters known as CAR-T cells.
- T-cells are special cells (white blood cells that find and fight illness and infection) whose primary function is cytotoxic, meaning it can kill other cells.
- In CAR-T therapy, we genetically modify them into cancer-fighting cells.
- These supercharged cells are then put back into the body, and they go after cancer cells — especially in blood cancers like leukemia and lymphomas.
Is India’s indigenous CAR-T cell therapy any more or less effective than CAR-T cell therapies abroad?
- Specifically, it leads to significantly lower drug-related toxicities.
- It causes minimal damage to neurons and the central nervous system, a condition known as neurotoxicity.
- Neurotoxicity can sometimes occur when CAR-T cells recognise the CD19 protein and enter the brain, potentially leading to life-threatening situations.
- The therapy also results in minimal Cytokine Release Syndrome (CRS), which is characterized by inflammation and hyperinflammation in the body due to the death of a significant number of tumor cells, as CAR-T cells are designed to target and eliminate cancer cells.
First CAR-T cell therapy to get CDSCO approval
- Immuno ACTs is the first CAR-T cell therapy to get CDSCO approval in many hospitals, including Chandigarh-based Postgraduate Institute of Medical Education and Research (PGIMER).
- They are also conducting groundbreaking clinical trials in the use of CAR-T cell therapy to treat cancer.
- The commercial use of this therapy to treat certain blood cancers was approved by the Central Drugs Standard Control Organisation (CDSCO) in October 2023.
- Pulitzer Prize-winning oncologist Siddhartha Mukherjea is also conducting his first phase II multicentre CAR-T cell therapy study. His start-up Immuneel is working on the therapy.
How effective and different is this from other cancer treatments like, say, chemotherapy?
- While chemotherapy and immunotherapy may add a few months or years to a cancer patient’s life, cell-and-gene therapy is designed to cure and provide lifelong benefit.
- It makes treatment easier with a one-time therapy (unlike several sessions of chemotherapy) that can be truly transformative for a patient.
- It’s a lifeline for non-responsive cancer patients.