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Introduction

CAR-T cell therapy represents a significant breakthrough in cancer treatment, offering new hope to patients with otherwise untreatable cancers. Chimeric Antigen Receptor T-cell (CAR-T) therapy is an advanced form of immunotherapy that harnesses the body’s own immune system to fight cancer.

  • In this therapy, a patient’s T-cells are genetically engineered to produce special receptors called chimeric antigen receptors (CARs) on their surface.
  • These CARs enable T-cells to recognize and attack specific proteins on the surface of cancer cells, particularly in certain types of blood cancers such as B-cell acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL).

The Process of CAR-T Cell Therapy

  1. T-cell Collection: T-cells are extracted from the patient’s blood through a procedure called leukapheresis.
  2. Genetic Modification: In the lab, these T-cells are modified using a viral vector to introduce the CAR gene, which encodes the chimeric antigen receptor. This receptor is designed to target a specific antigen found on the surface of cancer cells.
  3. Cell Expansion: The modified T-cells are then multiplied in large numbers in the laboratory to ensure that there are enough CAR-T cells to effectively target and kill the cancer cells.
  4. Reinfusion: After a conditioning regimen (often chemotherapy) to reduce the patient’s existing immune cells and make space for the CAR-T cells, the engineered cells are infused back into the patient.
  5. Monitoring: Patients are closely monitored for any adverse reactions, including cytokine release syndrome (CRS) and neurotoxicity, which are potential side effects of CAR-T therapy.

Potential Benefits in the Indian Health Landscape

  1. Addressing the Cancer Burden: India faces a growing cancer burden, with around 1.39 million new cancer cases reported in 2020. CAR-T therapy could provide a life-saving option for patients who have exhausted other treatment avenues.
  2. High Efficacy in Treatment: CAR-T therapy has shown high remission rates, particularly in patients with relapsed or refractory blood cancers.
  3. Advancement in Healthcare Infrastructure: The introduction of CAR-T therapy can drive the development of specialized healthcare infrastructure, including advanced laboratories and training for healthcare professionals.
  4. Potential for Cost Reduction and Accessibility: The Institute of Cytology and Preventive Oncology (ICPO) and IIT Bombay are working on developing low-cost CAR-T therapies, which could make this treatment more accessible to Indian patients.

Challenges in the Indian Health Landscape

  1. High Costs: The cost of CAR-T therapy in India can be prohibitively high, ranging from INR 3-4 crore.
  2. Infrastructure and Expertise: Implementing CAR-T therapy requires highly specialized infrastructure, including facilities for genetic modification and cell culture, as well as trained professionals.
  3. Side Effects and Management: CAR-T therapy can cause severe side effects, including cytokine release syndrome (CRS) and neurotoxicity.
  4. Regulatory and Ethical Considerations: The development and implementation of CAR-T therapies involve complex regulatory approvals and ethical considerations, particularly related to genetic modification.

Conclusion

With ongoing research and government support, there is potential to overcome these challenges and integrate CAR-T therapy into the Indian healthcare landscape.

Legacy Editor Changed status to publish July 14, 2025