Article on CAR-T cell therapy

The Chimeric Antigen Receptor T-cell (CAR-T) therapy has emerged as a breakthrough in cancer treatment.

Clinical trials conducted globally have shown promising results in end-stage patients, especially in patients suffering from acute lymphocytic leukemia.

The Indian Government has approved $2,624,959 for conducting a first-in-human phase-1/2 clinical trial of the CAR-T cells.

On June 4, India's first CAR-T cell therapy was done at the Bone Marrow Transplant unit at ACTREC, Tata Memorial Centre in Mumbai.

- what is this treatment all about?

- How does this treatment works?

- When can this be available in india?

- What type of patients are eligible or not eligible for this treatment?

- Advantages and disadvantages of this treatment?

- And other than all of this whatever the expert wants to say about this treatment?

1. CAR-T means chimeric antigen receptor T cells.

CART cells are a form of genetically modified autologous immunotherapy that can be directed at B cell precursor ALL.

 2. This is a  customized treatment that uses the individual's own T lymphocytes, which are transduced with a gene that encodes a chimeric antigen receptor to direct the patient's T cells against the leukemic cells. The T cells are genetically modified ex vivo, expanded in a production facility, and then infused back into the patient as therapy.

 3. So far in India, CART Cell therapy is not in routine practice.This treatment is still in its nascent stage in our country. I am not sure but when it will be available but I am certainly excited to see this treatment being available in our country. It is a highly specialised and personalised therapy.

 4. Eligible criteria: Currently, CAR T-cell therapy is FDA approved as standard of care for:

• Some forms of aggressive, relapsed or refractory non-Hodgkin lymphoma including diffuse large B cell lymphoma, primary mediastinal B-cell lymphoma, high grade B-cell lymphoma, transformed follicular lymphoma, mantle cell lymphoma
• Relapsed or refractory follicular lymphoma
• Relapsed or refractory multiple myeloma
• Relapsed or refractory acute lymphoblastic leukemia up to age 25.
• There are also many clinical trials of CAR T-cell therapy for other types of blood cancer and solid tumors.

5. Advantages :

• CAR T cell therapy is an epitome of hope in an ocean of uncertainty. It gives a glimmer of Hope to the patient in a relapse settings where most of the standard treatment has failed. 
• Can convert the cancer into Remission

6. Disadvantage:

• It is a highly specialised and personalised therapy. Hence available only in selected centres in the world.
• Expensive treatment 
• Requires Hospitalization for weeks
• Requires a dedicated centre and highly specialised team 
• Side effects : Cytokine release syndrome