India’s own CAR-T cell therapy

What’s in today’s article?

• Why in news?
• CAR-T cell therapy
• What is CAR-T cell therapy, and how do CAR-T cells find and destroy cancer cells?
• How effective and different is this from other cancer treatments like, say, chemotherapy?
• NexCAR19
• What is NexCAR19?
• Who can get the NexCAR19 therapy?
• Are children eligible for the therapy too?
• What are the side-effects of this therapy?
• How much will this treatment cost?

Why in news?

• NexCAR19 is India’s first indigenously-developed CAR-T cell therapy.
• Recently, the Central Drugs Standard Control Organisation (CDSCO) granted market authorisation for NexCAR19 to ImmunoACT, a company incubated by IIT Bombay.
• This paves the way for the commercial launch of this therapy in India, where it is expected to be available to cancer patients at a tenth of the cost abroad.

What is CAR-T cell therapy, and how do CAR-T cells find and destroy cancer cells?

• 
• CAR-T is a revolutionary therapy that modifies immune cells, specifically T-cells, by turning them into potent cancer fighters known as CAR-T cells.
• T-cells are special cells (white blood cells that find and fight illness and infection) whose primary function is cytotoxic, meaning it can kill other cells.
• CAR-T therapy, we genetically modify them into cancer-fighting cells.
• These supercharged cells are then put back into the body, and they go after cancer cells — especially in blood cancers like leukaemia and lymphomas.

How effective and different is this from other cancer treatments like, say, chemotherapy?

• While chemotherapy and immunotherapy may add a few months or years to a cancer patient’s life, cell-and-gene therapy is designed to cure and provide lifelong benefit.
• It makes treatment easier with a one-time therapy [unlike several sessions of chemotherapy].
• It is a lifeline for non-responsive cancer patients.

What is NexCAR19?

• NexCar19 is a type of CAR-T and gene therapy developed indigenously in India by ImmunoACT, which is a company incubated at IIT Bombay.
• This therapy is designed to target cancer cells that carry the CD19 protein.
  • This protein acts like a flag on cancer cells, which allows CAR-T cells to recognise and attach themselves to the cancer cells and start the process of elimination.
• India is now one of the first developing countries to have its indigenous CAR-T and gene therapy platform.

Who can get the NexCAR19 therapy?

• The therapy is for people with B-cell lymphomas who didnot respond to standard treatments like chemotherapy, leading to relapse or recurrence of the cancer.
  • B-cell lymphoma is a type of cancer that starts in white blood cells called lymphocytes.
  • Lymphocytes make antibodies, which are proteins that help fight infections.
  • They are often found in lymph nodes or other lymphoid tissues such as the spleen.
• Essentially, patients only need to give a blood sample at their clinic, and come back in 7-10 days for reinfusion.
  • The blood goes to the lab, where the T-cells are genetically modified. In a week to 10 days, these cells return to the clinic for patient reinfusion.
• Recovery typically occurs within two weeks after one cycle of the treatment.

Are children eligible for the therapy too?

• For now, ImmunoACT has received CDSCO approval for use in patients aged 15 years and older.
• The paediatric trial phase is currently underway at the Tata Memorial Hospital, in collaboration with IIT-Bombay.

What are the side-effects of this therapy?

• NexCar19leads to significantly lower drug-related toxicities. It causes minimal damage to neurons and the central nervous system, a condition known as neurotoxicit
  • Neurotoxicity can sometimes occur when CAR-T cells recognise the CD19 protein and enter the brain, potentially leading to life-threatening situations.
• The therapy also results in minimal Cytokine Release Syndrome (CRS).
  • CRS is characterised by inflammation and hyperinflammation in the body due to the death of a significant number of tumour cells, as CAR-T cells are designed to target and eliminate cancer cells.

How much will this treatment cost?

• Currently, the treatment at a price range of Rs 30-40 lakh and the target to the company is to bring it down to Rs 10-20 lakh.
• As technology matures and manufacturing processes improve, it is anticipated that the cost will decrease.

Q1) What are Lymphocytes?

Lymphocytes are a type of white blood cell that are part of the immune system. 

Q2) What is ImmunoACT?

ImmunoACT is a company that develops cell and gene therapies in India. The company was spun out of IIT-Bombay in 2018. ImmunoACT's mission is to provide affordable access to novel autologous CAR-T cell therapies.

Source: India’s own CAR-T cell therapy: What is it, when will it be available, and at what cost? | Down To Earth | Times of India