Apollo partners with Cellogen for cancer treatment, to start human trials for indigenous CAR-T therapy

Kharya's Cellogen intends to provide the bi-specific CART therapy in India at around Rs 35-40 lacs

The Apollo Hospital group has partnered with Cellogen Therapeutics to conduct human trials for an indigenous dual antigen third-generation CAR-T cell therapy amid a bid by several health startups to develop affordable and accessible cancer treatments.

Cellogen, a biotech start-up working in Cell & Gene therapy in India, and Apollo are developing a cutting-edge treatment using next-generation and more potent bispecific CAR-T cells that target CD19 and CD20 antigens simultaneously.

Chimeric antigen receptor T, or CAR-T, cells are a type of immunotherapy that uses the body's own immune system to fight cancer. They are made by taking a patient's T cells and engineering them to recognise and attack cancer cells.

An antigen is any substance that causes the immune system to produce antibodies against it.

“This innovative cellular therapy represents a significant leap forward in the fight against cancer, surpassing traditional treatments including single antigen targeting CARs currently being used. These bispecific CAR-T cells offer remarkable efficacy, long-term persistence, and the ability to overcome cancer's escape mechanisms, providing renewed hope for patients,” said Dr Gaurav Kharya, Founder and Director at Cellogen Therapeutics.

Kharya also heads the Centre for Bone Marrow Transplant & Cellular Therapy at Indraprastha Apollo Hospitals, Delhi.

What is Bispecific CAR T Cell therapy?

Kharya explained that unlike conventional monospecific second-generation CAR-T cells, bispecific CAR-T cells demonstrate superior effectiveness.

“They are designed to identify and bind to both CD19 and CD20 antigens simultaneously, making the targeting of cancer cells more accurate and efficient. This dual approach increases the chances of eradicating cancer cells, leading to improved treatment outcomes,” he added.

Noting that cancer was a major public health problem in India, with over 1.5 million new cases diagnosed each year, Kharya said the cancer incidence in India has been rising steadily over the years.

“The current mortality rate from cancer in India is high, with over 800,000 people dying from the disease every year. The economic cost of cancer in India is estimated to be over $10 billion per year. At present, there is no long-term treatment available for relapsed and refractory cancer patients in India. Importantly, the advanced CAR-T cell therapies have the potential to permanently treat cancer,” he added.

Explaining the significance of bispecific CAR-T therapy, Kharya said this is a new type of CAR-T cell that can target two different antigens on cancer cells.

“This makes them more effective at killing cancer cells and reduces the risk of cancer cells developing resistance to treatment. In clinical trials, bispecific CAR-T cells have been shown to be effective in treating a variety of cancers, including acute lymphoblastic leukaemia (ALL), chronic lymphocytic leukaemia (CLL), and non-Hodgkin lymphoma (NHL),” he added.

Human trials to begin soon

The director of Cellogen Therapeutics said it is currently manufacturing bispecific CAR-T cells for clinical trials in India. “We plan to make this state-of-the-art treatment available to patients in India as soon as possible at an affordable cost,” he added.

Studies have shown that the next-generation bispecific CAR-T cells have an exceptional ability to persist within the body for an extended period.

Hence, these cells are engineered to have enhanced longevity, enabling them to remain vigilant and swiftly identify and eliminate any cancer cells that might reappear in the future. This long-term persistence significantly reduces the risk of cancer recurrence and offers patients a higher chance of achieving long-lasting remission.

Noting that the cancer cells evade treatments by altering or losing the targeted antigens, Kharya said bispecific CAR-T cells address a critical challenge known as antigen escape.

“Using conventional second-generation monospecific CAR-T cells has around 50 percent chance of cancer recurrence within 2 years for patients who do not achieve complete remission (CR) after treatment. This is because cancer cells can sometimes lose the CD19 antigen, which is the target of CAR-T cells and developed in CD20 clone. However, the dual-targeting mechanism of bispecific CAR T cells combats this issue. Even if cancer cells modify or lose one antigen, the other antigen remains a viable target for the therapy, preventing antigen escape and maintaining the treatment's effectiveness,” Kharya explained.

Affordability factor

The Cellogen Director said affordability was another significant aspect of bispecific CAR-T cell therapy.

He said Cellogen intends to provide this state of art bi-specific CART therapy at around Rs 35-40 lacs which shall be less than one tenth the cost of monospecific 2nd generation CART in the US and Europe.

In the United States, the cost of CAR-T cell therapy for FDA-approved treatments such as Kymriah and Yescarta has been reported to be approximately $480,000 (equivalent to around Rs 4 crore). This cost does not include additional expenses like hospital charges, which can range from Rs 5 crore.

“At Cellogen Therapeutics, we have streamlined the manufacturing process, making it cost-effective. We firmly believe that bispecific CD19 and CD20 targeting CAR-T cells have the power to transform the landscape of cancer treatment. This breakthrough technology has the potential to revolutionise cancer care by making effective cellular therapies more accessible and affordable for patients in India and beyond,” he said.

“We are excited about the new avenues of hope this therapy brings to patients and their families in India and across the globe,” he added.