CAR T-cell Therapy

Context

• Oncologists explain the importance of CAR T-cell technology in curing people with leukemia and lymphomas.

Key Takeaways

• Leukaemia is a type of cancer that affects the blood and bone marrow, while lymphoma is a type of cancer that starts in the cells of the lymphatic system, which is part of the immune system.
• Ar present,there are three major forms of treatment for any cancer viz.,
  • Surgery: removing the cancer
  • Radiotherapy: delivering ionising radiation to the tumour
  • Systemic therapy: administering medicines that act on the tumour.
• CAR T-cell therapy is a quantum leap in sophistication in treating these cancers and uses the patient’s own cells, which are modified in the lab to attack tumours.
• Although the world’s first clinical trial was published a decade ago,the first indigenously developed therapy was done in India in 2021.
• At present, the cost of treatment is high, over $1 million in the US, with trials underway in India for indigenously manufactured CAR T-cells at a lower cost.
• As per U.S.-based experts, India is expected to face a ‘tsunami’ of chronic diseases like cancer.

What is CAR T-cell Therapy?

• About: Systemic therapy primarily includes:
  • Chemotherapy: preferentially acts on cancer cells but has modest response rates and significant side-effects
  • Targeted agents (immunotherapy): drugs bind to specific targets on cancer cells, has fewer side-effects but is effective only against certain tumours
• Unlike chemotherapy or immunotherapy, which require mass-produced injectable or oral medication, CAR T-cell therapies use a patient’s own cells to attack tumours.
• In this therapy, modified cells are infused back into the patient’s bloodstream to activate their immune system against cancer resulting in a more clinically effective treatment, also known as “living drugs”

Advantages of CAR T-cell therapy

• Personalized Medicine: CAR T-cell therapy is a personalized form of cancer treatment, as the patient’s own immune cells are used to create the CAR T cells.
• High Efficacy: Clinical trials have shown that CAR T-cell therapy can be highly effective in treating certain types of cancer, particularly blood cancers such as leukemia and lymphoma.
• Long-lasting response: The CAR T cells can persist in the body for a long time, providing long-lasting immunity against cancer cells.
• Minimal side effects: Compared to traditional chemotherapy and radiation treatments, CAR T-cell therapy has fewer side effects.
• Improved Quality of Life: Patients who receive CAR T-cell therapy may experience an improved quality of life, with less fatigue and fewer side effects than traditional cancer treatments.
• Targeted Therapy: It is a targeted form of therapy, meaning it only attacks cancer cells, reducing the risk of damage to healthy cells and tissues.
• Non-invasive: Unlike traditional cancer treatments, CAR T-cell therapy is a non-invasive procedure, with the CAR T cells being infused into the patient’s bloodstream.
• Potential for cure: It has the potential to cure cancer, particularly in patients with otherwise untreatable diseases.

Challenges in India

• Complexity of preparation: CAR T-cell therapy requires technical and human resources, making it challenging to administer.
• Cost: Treatments in the US can cost over a million dollars, making it unaffordable for many patients.
• Availability: The complexity of preparation has been a major barrier to widespread use, with the first clinical trial showing its effectiveness only a decade ago.
• Value and access: In India, introducing the therapy faces challenges related to cost and access, with critics arguing that it may not be appropriate or affordable even if made cheaper.
• Side-effects: CAR T-cell therapy can have significant potential side-effects, such as cytokine release syndrome (widespread activation of the immune system) and neurological symptoms.
• Response rate: The response rate of CAR T-cell therapy can be variable, with efficacy as high as 90% in some leukaemias and lymphomas but significantly lower in other types of cancers.

Source: TH