CAR T-Cell Therapy for Cancer Treatment

Over other forms of treatment, the new CAR T-Cell Immunotherapy holds promise for Ovarian Cancer patients.

Chimeric antigen receptor (CAR) T-cell therapies represent a quantum leap in cancer treatment sophistication.
CAR T-cell therapies use a patient’s own cells, as opposed to chemotherapy or immunotherapy, which require mass-produced injectable or oral medication.
They are genetically modified in the lab to activate T-cells, a type of immune cell, to attack tumours.
After conditioning the cells to multiply more effectively, they are infused back into the patient’s bloodstream.
The cells are more specific than targeted agents and directly activate the patient’s immune system against cancer, increasing clinical efficacy.
This is why they’re called ‘living drugs’.

CAR T-cell therapy involves drawing the patient’s blood to harvest T-cells, which are immune cells that play an important role in destroying tumour cells.
In the laboratory, researchers modify these cells so that they express specific proteins on their surfaces, known as chimeric antigen receptors (CAR).
They have a preference for proteins found on the surface of tumour cells.
This change in cellular structure allows CAR T-cells to effectively bind to and destroy tumours.
The patient’s immune system clears the tumour as the final step in its destruction.

As of today, CAR T-cell therapy has been approved for leukaemias (cancers arising from the cells that produce white blood cells) and lymphomas (arising from the lymphatic system).
These cancers are caused by the uncontrolled reproduction of a single clone of cells, which means that after a single type of cell undergoes cancerous transformation, it produces millions of identical copies.
As a result, the CAR T-cell target is consistent and reliable.
CAR T-cell therapy is also used in patients whose cancers have returned after a successful initial treatment or who have not responded to previous chemotherapy or immunotherapy combinations.
Its response rate varies. The efficacy in certain types of leukaemias and lymphomas can reach 90%, whereas it is significantly lower in other types of cancer.

The difficulty in preparing CAR T-cells has been a major impediment to their use.
The first clinical trial demonstrating their efficacy was published nearly a decade ago, but the first indigenously developed therapy in India was only successfully performed in 2022.
This therapy necessitates a significant amount of technical and human resources.
Treatments in the United States can cost more than a million dollars.
Trials are currently underway in India, with companies attempting to manufacture CAR T-cells at a fraction of the cost.
The preliminary findings are encouraging.

Surgery (removing the cancer), radiotherapy (delivering ionising radiation to the tumour), and systemic therapy are the three main types of cancer treatment (chemotherapy- administering medicines that act on the tumour only).
Surgery and radiotherapy have been greatly refined over time, while advances in systemic therapy have been unprecedented.
CAR T-cell therapy is a new development in this field that is capturing the attention of many researchers worldwide.

Any new therapy introduced in India faces the twin challenges of cost and value.
Critics argue that developing facilities in India may be redundant and/or inappropriate because CAR T-cell therapy will be unaffordable to the majority of Indians even if it becomes cheaper.
Those who can afford it and need it are already receiving it abroad.
While this is correct, it may be the correct answer to the incorrect question.
Every patient has the right to access a global standard of care; the next step is to figure out how to make it more affordable.

Source: https://www.cancer.gov/about-cancer/treatment/research/car-t-cells