A Delhi-based doctor, who was suffering from a rare and aggressive form of blood cancer, has become the first commercial patient in India to be cured using an indigenous CAR-T cell therapy. The therapy, NexCAR19, is developed by ImmunoACT and Tata Memorial Hospital, and costs only a fraction of the imported versions.
What is CAR-T cell therapy and how does it work?
CAR-T cell therapy is a type of immunotherapy that uses the patient’s own immune cells to fight cancer. CAR stands for chimeric antigen receptor, which is a protein that can recognize and bind to specific antigens on the surface of cancer cells. T cells are a type of white blood cell that can kill infected or abnormal cells.
In CAR-T cell therapy, the patient’s blood is collected and the T cells are separated and genetically modified to express CARs. These modified T cells, called CAR-T cells, are then multiplied in the laboratory and infused back into the patient. The CAR-T cells can then seek and destroy the cancer cells, while sparing the normal cells.
How did the therapy cure the patient?
The patient, Dr (Col) V K Gupta, a gastroenterologist with 28 years of experience in the Indian Army, was diagnosed with mantle cell lymphoma, a rare and aggressive form of non-Hodgkin’s lymphoma, in 2020. He underwent chemotherapy and stem cell transplant, but the cancer relapsed twice. He was given only a few months to live.
He then opted for the NexCAR19 therapy, which was approved by the Central Drugs Standard Control Organisation (CDSCO) in November 2023. He received the therapy at the Tata Memorial Hospital in Mumbai, under the supervision of Dr Hasmukh Jain, a hemato-oncologist and associate professor.
The therapy involved collecting his blood and sending it to ImmunoACT’s facility in Pune, where the T cells were engineered and expanded. The CAR-T cells were then transported back to Mumbai and infused into the patient. The patient experienced some side effects, such as fever, low blood pressure, and cytokine release syndrome, which were managed with supportive care.
After four weeks, the patient underwent a PET scan, which showed that he was free of cancer cells. He also had a bone marrow biopsy, which confirmed the absence of cancer. He is now in complete remission and has resumed his normal life.
What are the benefits and challenges of the therapy?
The NexCAR19 therapy is India’s first indigenously-developed CAR-T cell therapy, which offers several benefits over the imported versions, such as:
- It is more affordable and accessible, costing only Rs 42 lakh, compared to Rs 4 crore for the imported versions
- It is more customized and tailored to the Indian population, taking into account the genetic and environmental factors
- It is more effective and safe, showing better survival chances and lower remission rates for the patients
However, the therapy also faces some challenges, such as:
- It is still in the early stages of development and needs more clinical trials and data to establish its long-term efficacy and safety
- It is not a one-size-fits-all solution and may not work for all types of cancers or patients
- It requires a high level of expertise and infrastructure to produce and administer the CAR-T cells
What does this mean for India and the world?
The successful cure of the patient using the NexCAR19 therapy is a landmark achievement for India and the world, as it demonstrates:
- The potential of CAR-T cell therapy to revolutionize the treatment of cancer and save millions of lives
- The capability of India to develop and deliver cutting-edge and affordable healthcare solutions
- The collaboration and innovation of the Indian scientific and medical community to address the unmet needs of the patients
The NexCAR19 therapy is a milestone in the field of cell and gene therapy, and a ray of hope for the cancer patients in India and the world.