Cure for cancer: What is CAR-T therapy, the miracle treatment that uses body’s own immune system

It’s a story of medical marvel that saved the life of a 6-year-old from a deadly cancer. Ishwari Bagirao was diagnosed with acute lymphocytic leukaemia (ALL), a type of cancer of the blood and bone marrow, and despite undergoing several rounds of painful chemotherapy at Tata Memorial Centre in Mumbai, the cancer kept recurring. But Ishwari’s story took a remarkable turn with CAR-T cell therapy, a type of immunotherapy that uses the power of your body’s immune system to fight cancer. Ishwari, now 9, has been cancer free for over 1.5 years now.

Dr Gaurav Narula, Pediatric Onco head and lead on CAR-T project, who made this miracle happen, and his team of doctors, have made the treatment commercially available in just under Rs 50 lakh, as compared to its Rs 4 crore price tag in the US.

So what is this CAR-T treatment that’s giving life to those who seem to be losing their battle to cancer? Here’s everything you need to know about it.

What is CAR-T? 

CAR-T cell therapy involves genetically modifying a particular cell in the patient's body, called T cells, to better recognise and attack the cancer cells. The T of the CAR-T cell therapy comes from this.

How does it work?

First, blood is drawn from the patient’s body. Then, doctors remove a special type of white blood cell called T cells from the blood, which are then programmed in a lab so they can recognise and attack cancer cells. Finally, they put these modified T cells back into the patient's body to fight the cancer.

The modification of the T cell is the most fascinating part of the therapy. The scientists have given a weapon to your existing T cells in your blood, arming them with spikes that attack the cancer cells in your body and and destroy them. Unlike Chemotherapy, which attacks the cancer cells but also destroys the healthy cells, CAR-T is targeted only at cancer.

What type of cancers can CAR-T treat?

CAR-T cell therapy has shown promise in treating mostly blood cancers, such as acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), and certain types of lymphomas.

Is it available in India, and how much does it cost?

In 2017, the US approved CAR-T therapy for the first time, costing over $ 4 lakh (Rs 4 crore approximately). But in June 2021, Dr Narula’s team began clinical trials with Tata Memorial Centre and IIT Mumbai, and got it approved for commercial launch in India in just two years. Private hospitals, too, can buy this therapy, which has been administered to 15 patients so far, out of which three are cancer-free now.

Says Dr Narula, “When we started out, the therapy was not approved and there was no price tag to it. The only way we could keep the costs down was if we did it ourselves in India. Right now the approval has come only for B-cell leukemias and lymphomas.” When asked about the side-effects of the therapy, Dr Narula says, “One major side-effect of this therapy is Cytokine Release Syndrome which occurs because these are immune cells which release a lot of cytokines that kill the cancer cells. It can cause high grade fever, or low oxygen issues. However, we expect everybody to recover from them. This therapy is exceptionally safe. We’ve not had a single child going into the ICU for Cytokine Release syndrome. Another side-effect is neuto-toxicity which can occur in one third of the patients.”

Watch the full interview with Dr Narula here