All about CAR-T cell therapy

Cancer treatment is getting more and more customized according to the patient’s DNA.

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KEY HIGHLIGHTS

  • A cancer survivor in the UK, who feared that the massive dose of chemotherapy that she had been administered had rendered her infertile, has now given birth to a baby boy.
  • What is this revolutionary Chimeric antigen receptor (CAR) T-cell therapy that represents a major advancement in personalized cancer treatment?

Where cancer research and treatment are concerned, thankfully, the world is making rapid strides in better and more potent treatments.

But nothing that involves chemicals and drugs can come without the risk of side effects. One such young cancer-stricken UK woman’s fears that the intensive chemotherapy she had received had left her infertile have been proven to be unfounded as the couple has welcomed a ‘miracle’ baby.

So, what was this miraculous anti-cancer treatment that this woman named Sammy Gray had been given?

As per a report in the UK newspaper The Daily Mail, Sammy Gray, 26, has become one of the first women in the UK to give birth following a pioneering treatment called CAR-T cell therapywhich trained her body to fight the disease.

Shortly after the birth of her daughter Harper in 2018, Sammy had been found to have developed a cancerous mass on her chest that turned out to be non-Hodgkin’s lymphoma, a rare cancer of the matic system — part of the body’s immune system.

Doctors treated her with chemotherapy and radiotherapy, which shrunk her tumour. But then cancer became more aggressive and progressed.

Out of treatment options by 2019, doctors at Manchester’s Christie NHS Foundation Trust decided to try CAR-T (chimeric antigen receptor T-cellcell therapy.

What is CAR-T (chimeric antigen receptor T-cell) cell therapy?

CAR-T is a type of immunotherapy which involves reprogramming the patient’s own immune system cells. These cells then work to target cancer in the patient’s body. The treatment carries risks but has managed to cure some patients, even those with quite advanced cancers and where other treatment options have failed.

The patient’s blood sample is sent to labs in the US where the cancer patient’s T-cells are genetically modified. The treated cells are then put back into the patient’s body via a drip, with the hope of boosting the immune system’s natural response to cancer.

The treatment is quite strong and made Ms Gray feel very ill. She had to remain hospitalized but after a month, she was allowed to go home. The treatment worked and three, six and 12-month scans gave her the all-clear, showing no signs of cancer.

Cancer treatments can leave women infertile and Ms Gray did not have periods for a year while she was being treated.

To the couple’s surprise, she conceived naturally and their son Walter was born on February 23 this year.

‘Walter is our little miracle. If it wasn’t for the CAR-T treatment at the Christie (the NHS medical facility) neither of us would be here now,” she told the UK daily.

Is the revolutionary cancer treatment CAR-T therapy available in India?

This cancer called non-Hodgkin’s lymphoma is a grave and aggressive disease and only 55 per cent of people diagnosed with this type of cancer go on to survive for 10 or more years, say studies. Is it available in India? Here’s what a study paper by US and India collaborators says:

“Chimeric antigen receptor (CAR)-T cell therapy has revolutionized the treatment of some kinds of cancers …The individualized, custom-made autologous CAR-T cell production platform remains a significant limiting factor for its large-scale clinical application.

…Despite the wide use of this cell therapy in the United States, Europe and China, its development is limited in developing countries in Southeast Asia, Africa and Latin America.”

The study authors suggest that in this review, they focus on good manufacturing practices-compliant manufacturing requirements, operational logistics, and regulatory processes that need to be considered for high-quality gene-modified cell therapies from an Indian perspective. Challenges in affordability and scalability will need to be worked on by the stakeholders.

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