Cell therapy gives hope to cancer patients

NEW DELHI: There is a ray of hope for cancer patients aged 15 years and above who don't respond to conventional chemotherapy or bone marrow transplant as the "made-in-India" CAR-T cell therapy for treatment of B-cell lymphomas and B-acute lymphoblastic leukaemia will be commercially available at a private hospital in Delhi.

Between Nov 2022 and Dec 2023, the Apollo group of hospitals successfully provided this therapy to six patients - five adults and one child - across their centres outside Delhi. Four of them received indigenous therapy as part of clinical trials, including a Delhi resident, and two patients had access to international CAR-T cells commercially.

Dinesh Madhavan, president group, oncology and international, at Apollo Hospitals Enterprises Ltd, told TOI that three of these patients who successfully completed the treatment had crossed one year and were doing well. "At least 10 other patients are in the process of getting the indigenous CAR-T cell therapy," he said, adding that it would now be available commercially.

Whether indigenous or overseas therapy, "the treatment will cost between Rs 75 lakh and Rs 90 lakh at the centres," said Madhavan. The indigenous therapy has got an approval for the treatment of B-cell lymphomas and B-acute lymphoblastic leukaemia for above 15 years while the overseas one can have access to beyond B-cell, he added.

A 32-year-old academic counsellor from Chennai, who received CAR-T cell therapy in Jan 2023, told TOI that it was difficult for her to be isolated from the family for over a month for getting treatment, but now she was absolutely fine. "Now I can do my job along with household work," she said.

Doctors said CAR-T cell therapies, often called living drugs, involve the extraction of a patient's T cells - a type of white blood cells whose function is to fight cancer cells - through a process called apheresis. These T-cells are genetically modified by a safe vehicle (viral vector) in a controlled laboratory setting so that they express modified connectors on their surface called chimeric antigen receptors (CARs). These CARs are specifically designed to recognise a protein that is abnormally expressed on certain cancer cells. They are then multiplied to a desired dose and infused directly into the patient.

Dr Shisir Seth, senior consultant of haematology at Apollo Cancer Centre, said these cases highlighted the efficacy and potential of this transformative therapy in providing new hope for such patients.

Dr Amita Mahajan, senior consultant of paediatric oncology & haematology, said the therapy was provided to those patients who failed all standard treatments. "The CAR-T cell is currently standard of care for three diseases - adult acute lymphoblastic leukemia, lymphomas and myeloma. This particular CAR-T cell, NexCAR19, is sanctioned for leukaemia and lymphomas, and the others are also about to come very shortly," she said, adding the treatment showcases the potential and efficacy of this transformative approach in addressing challenging B-cell malignancies.