India’s own CAR-T cell therapy: Cancer treatment

India’s own CAR-T cell therapy

Context: The Central Drugs Standard Control Organisation (CDSCO) has granted market authorisation for NexCAR19, India’s first indigenously-developed CAR-T cell therapy, to ImmunoACT, a company incubated by IIT Bombay. 

  • This paves the way for the commercial launch of the therapy in India, where it is expected to be available to cancer patients at a tenth of the cost abroad.
  • For now, ImmunoACT has received CDSCO approval for use in patients aged 15 years and older.
CAR T-cell Therapy

What is CAR-T cell therapy?

  • 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.
  • In CAR-T therapy, the T-cells are genetically modified into cancer-fighting cells. These supercharged cells are then put back into the body, and they kill cancer cells — especially in blood cancers like leukaemia and lymphomas.
  • India is one of the first developing countries to have its indigenous CAR-T and gene therapy platform.

About 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. 
  • The 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.
  • The therapy is for people with B-cell lymphomas who did not respond to standard treatments like chemotherapy, leading to relapse or recurrence of the cancer.
    • Recovery typically occurs within two weeks after one cycle of the treatment. In our data, approximately 70% of patients respond to the treatment, with variations between leukaemia and lymphoma cases.
    • About 50% of these responsive patients achieve a complete response.
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CAR-T therapy vs other treatments:

  • 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] that can be truly transformative for a patient. It is a lifeline for non-responsive cancer patients.

Q1. Consider the following statements with reference to the CAR T-cell therapy:

1. In this therapy the T-cells are genetically modified into cancer-fighting cells.

2. The treatment is effective against all types of known cancers.

3. The therapy does not have any known side effects.

How many of the statements given above are correct?

(a) Only one

(b) Only two

(c) All three

(d) None

Answer: (a) 

Explanation:

Statement 1 is correct: Chimeric antigen receptor (CAR) T-cell therapy is a type of cell-based gene therapy which involves altering the genes inside T-cells (a type of white blood cell) to help them attack cancer cells.

    • In the therapy, T-cells are harvested from the patient’s blood.
        • Researchers modify these cells in the laboratory so that they express specific proteins on their surface known as chimeric antigen receptors (CAR).

        • These cells are then grown and multiplied in the laboratory and then inserted back into the patient.

        • This genetic modification allows CAR T-cells to effectively bind to the cancer cells and destroy them.

As CAR-T cells directly activate the patient’s immune system against cancer, it

makes the treatment more clinically effective than surgery, Radiotherapy and

Chemotherapy.

Statement 2 is incorrect: Presently, CAR T-cell therapy has been approved for leukaemia

(cancer arising from the cells that produce white blood cells) and lymphoma (arising from

the lymphatic system). For these cancers, the efficacy of the treatment is as high as 90%,

whereas, in other types of cancers, it is significantly lower.

Statement 3 is incorrect: The treatment has potential side effects:

    • High fever

    • Trouble breathing

    • Severe nausea, vomiting

    • Muscle and/or joint pain

    • Neurological symptoms like severe confusion, seizures, and speech impairment.


UPSC PYQ 2021

Q. With reference to recent developments regarding Recombinant Vector Vaccines and consider the following statements:

1. Genetic engineering is applied in the development of these vaccines.

2. Bacteria and viruses are used as vectors.

Which of the statements given above is/are correct?

(a) 1 only

(b) 2 only

(c) Both 1 and 2

(d) Neither 1 nor 2

Answer: (c)

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