India has its own CAR-T cell therapy centre. Here’s what this therapy is all about

The Central Drugs Standard Control Organisation (CDSCO) granted commercial approval for CAR-T cell therapy recently.

This therapy is known for its ability to genetically re-programme the immune system of patients to combat cancer.

It is designed to treat various diseases, including acute lymphocytic leukaemia, multiple myeloma, glioblastoma, and hepatocellular carcinoma.

Also Read: What is CAR-T cell therapy and how can it help ‘cure cancer’?

What is CAR-T cell therapy?

Think of the human body as a superhero team, which has special members called T cells. These T cells defend the body from micro-organisms like germs and viruses.

Now, sometimes, there’s a sneaky villain called cancer that regular T cells find hard to beat. But scientists have devised an idea to make these T cells even more powerful.

They take out some T cells, kind of like assembling a superhero squad, and give them a special power called CAR (Chimeric Antigen Receptor).

Once the T cells are all powered up with their new CAR, they are sent back into your body to fight off the cancer cells. This CAR helps the T cells spot and attack cancer cells. This is called CAR-T cell therapy.

The process involves collecting T cells from the patient’s blood and genetically altering them in the laboratory to produce CARs that recognise and bind to specific proteins, or antigens, on the surface of cancer cells.

The modified T cells are then infused back into the patient’s bloodstream, where they multiply and attack the cancer cells.

CAR-T cell therapy has been a decades-long journey — from when the technology was first proposed in the late 1980s, to the US Food and Drug Administration (FDA) giving its approval of the therapy in 2017.

Also Read: 50-year-old woman becomes first person to receive CAR-T cell therapy

‘A new hope for the whole of humankind’

President Murmu said that the launch of India’s first gene therapy is a major breakthrough in our battle against cancer. As this line of treatment, named “CAR-T cell therapy”, is accessible and affordable, it provides a new hope for the whole of humankind. She expressed confidence that it will be successful in giving new lives to countless patients.

President Murmu said that CAR-T cell therapy is considered to be one of the most phenomenal advances in medical science. It has been available in developed nations for some time, but it is extremely costly and beyond the reach of most patients around the world. She was happy to note that the therapy being launched in India is the world’s most affordable CAR-T cell therapy.

She said that this is a praiseworthy example of academia-industry partnership, which should inspire many more similar efforts.

Thank you, Hon’ble President Smt Droupadi Murmu @rashtrapatibhvn
for dedicating to the nation the first CAR-T – a collaborative effort from @TataMemorial and @iitbombay
Indian science at its best.https://t.co/fAfAiWvrpP

— Tata Memorial Hospital (@TataMemorial) April 4, 2024

Also Read: Everything you need to know about India’s top 5 major cancers

The India story

Cancer remains a significant public health challenge in India, with approximately 16 lakh new diagnoses reported in 2023.

Despite the widespread prevalence of cancer across the country, access to innovative treatments remains limited.

One such treatment, CAR-T cell therapy, is known for its efficacy, but is hindered by severe side effects and high costs, making it inaccessible for many patients.

In 2015, Dr Alka Dwivedi, then a graduate student at IIT Bombay, and her team addressed these challenges by modifying CAR-T cells to carry more human-like antibodies.

This groundbreaking effort resulted in the development of NexCAR19, an indigenous CAR-T cell therapy tailored for blood cancers like leukaemia and lymphoma.

Notably, NexCAR19 is not only effective but also available at a more reasonable cost, addressing the unique needs of patients within India’s healthcare system.

The administration of NexCAR19 involves a single intravenous infusion following chemotherapy. Collaboratively developed by ImmunoACT, a company incubated at the Indian Institute of Technology Bombay (IIT-B), and Tata Memorial Hospital, the therapy has already been successfully administered to 15 patients in India.

In a historic move, Kokilaben Dhirubhai Ambani Hospital in Mumbai became the first to offer CAR-T cell therapy to cancer patients in January of this year.

Overcoming the challenge of developing this technology cost-effectively, a significant milestone was achieved on 4 June, 2021.

On this day, the first CAR-T cell therapy was conducted at the bone marrow transplant unit at ACTREC, Tata Memorial CentRE in Mumbai, using CAR-T cells designed and manufactured at the Bioscience and Bioengineering (BSBE) department of IIT Bombay.

In October 2023, NexCAR19 became India’s inaugural CAR-T cell therapy to receive approval from the CDSCO.

This endorsement followed extensive trials involving 64 individuals diagnosed with advanced lymphoma or leukaemia.

The findings, disclosed at the American Society of Hematology meeting in December 2023, revealed that 67 percent of participants (36 out of 53) across the two trials experienced a significant reduction in their cancer’s extent (objective response).

Additionally, approximately half of these patients achieved a complete response, where the cancer disappeared entirely.

(Edited by Kamna Revanoor)