Chimeric Antigen Receptor (CAR)-T Cell T Therapy

In News

• Recently, the researchers have said that India’s first indigenously developed Chimeric Antigen Receptor (CAR)-T Cell T therapy for specific types of cancer patients has shown promising results and could be the safest therapy in this category so far.

What is CAR-T cell therapy?

• CAR-T cells are a patient’s own immune cells that are genetically engineered in the laboratory to fight cancer.
  • CAR-T cell is a prospective therapy that has ushered in a new era of curing refractory and stubborn cancers.
• CAR T cell therapy is used as third or second-line treatment for patients of specific types of cancers of blood and lymph nodes. In India, those willing to undergo this treatment have to travel to other countries, mostly the US. 
• T-cell receptor is widely used in developed nations for immunotherapy during cancer treatment.
  • However, the technology was not available in India yet.

How does it work?

• The therapy targets leukaemia and lymphoma.
  • Leukaemia is cancer of blood-forming tissues, including bone marrow.
  • Lymphoma is a cancer of the lymphatic system, which is part of the body’s germ-fighting network.
• It uses lentiviral technology.
  • In gene therapy, this is a method of inserting, modifying, or deleting genes in organisms using lentivirus, a family of viruses responsible for diseases such as AIDS (acquired immunodeficiency syndrome).
• As part of the treatment, a specific type of white blood cells called T cells are changed in the lab so they can find and destroy cancer cells.
• It is also sometimes referred to as a type of cell-based gene therapy because it involves altering genes inside T cells to help them attack cancerous cells.

In What types of cancer can it be used?

• The therapy is mostly effective in blood cancer and lymphoma (cancer beginning in the cells of the lymph system).
  • In India, about 40,000-50,000 patients of these cancers are diagnosed every year.

Significance 

• HCAR19 therapy 
  • The participants received autologous HCAR19 therapy (humanised CAR 19 therapy developed by IIT Bombay and it was observed that there were no dose-limiting toxicities and only low grade Cytokine Release Syndrome (CRS) was seen in 40 percent of participants.
• No neurotoxicity syndrome
  • None of the participants had immune effector cell-associated neurotoxicity syndrome.
• Safer version
  • Overall, the novel humanised HCAR19 tested in phase one clinical trials for adult lymphoma was found to be safe and has shown promising early signs of activity.
• No deaths
  • Post-CAR-T cell therapy none of the participants required ICU admission and there were no CAR-T treatment related deaths.

Therapy in India/ Way forward 

• Two start-ups
  • ImmunoACT along with Immuneel Therapeutics are two startups currently working to make CAR T cell therapy available in India.
• Low cost therapy
  • Both of these companies have said the therapy would be available in the country at a fraction of cost charged for the treatment in the developed countries like the US where it can cost about Rs 2-3 crore.

Source: HT