UPSC CURRENT AFFAIRS – 18 March 2025

Home UPSC Current Affairs Study of CAR T-Cell therapy trial in India, in Leukaemia Patients

Study of CAR T-Cell therapy trial in India, in Leukaemia Patients

Why in News:

A recent study on India’s CAR T-cell therapy, developed by IIT Bombay and Tata Memorial Hospital, reported a 73% response rate for B-cell blood cancers, offering a cost-effective alternative to global treatments.

Introduction

Chimeric Antigen Receptor (CAR) T-cell therapy has emerged as a transformative approach in cancer treatment, particularly for blood cancers such as B-cell leukaemia and lymphoma.
A recent study published in The Lancet Haematology has reported a remarkable 73% response rate among patients undergoing this therapy.
The clinical trials, conducted by researchers from the Indian Institute of Technology (IIT) Bombay and Tata Memorial Hospital, Mumbai, mark a significant milestone in India’s cancer treatment landscape.

CAR-T Cell Therapy

CAR-T cell therapy (Chimeric Antigen Receptor T-cell therapy) is an advanced immunotherapy that harnesses a patient’s own immune cells to fight cancer.
CAR T-cell therapy involves genetically modifying a patient’s T-cells, a type of immune cell, to target and destroy cancer cells.
CAR T-cell therapy offers a targeted approach, minimizing damage to healthy cells while enhancing the immune system’s response against malignancies.
It is approved for treating leukemias and lymphomas and is often called a “living drug.”
Procedure:

- T-Cell Collection – T cells (a type of white blood cell) are extracted from the patient’s blood via apheresis.
- Genetic Modification – These cells are engineered in a lab to express CAR proteins, enabling them to recognize and bind to cancer-specific antigens.
- Expansion & Infusion – The modified T cells are multiplied and infused back into the patient, where they target and destroy cancer cells.

Addressing Treatment Gaps

For patients with relapsed or refractory B-cell malignancies—where standard treatments fail—options have been limited. B-cells play a crucial role in the immune system, and their uncontrolled proliferation can lead to severe complications.
The clinical trials of CAR T-cell therapy in India provide an additional treatment avenue, offering hope to patients who previously had limited alternatives.

Clinical Trials and Observations

The study involved two phases:

Phase-1: Included 14 patients with relapsed or refractory B-cell lymphoma.
Phase-2: Expanded to 50 patients aged 15 and above, diagnosed with B-cell leukaemia or lymphoma.

Among the 51 patients analyzed, 73% responded positively to the therapy. However, some side effects were noted, including neutropenia (low neutrophil count) in 55 out of 57 patients, thrombocytopenia (low platelet count) in 37 patients, and anaemia in 35 patients. Despite two treatment-related fatalities, the overall safety profile was deemed manageable.

About T Cells

T cells, or T lymphocytes, are a type of white blood cell essential for the immune system.
They are responsible for cell-mediated immunity, enabling the body to detect and combat pathogens like viruses, bacteria, and cancer cells.
There are two main types:
- Helper T cells – Support and activate other immune cells.
- Cytotoxic T cells – Directly destroy infected or cancerous cells.

Benefits of CAR-T Cell Therapy

High Effectiveness – CAR-T therapy has shown remarkable success in treating blood cancers like leukemias and lymphomas, leading to long-term remission in some patients.
Personalized Treatment – Since CAR-T cells are derived from the patient’s own immune system, there is a lower risk of rejection compared to traditional therapies.
Long-Lasting Immunity – The modified T cells can persist in the body, offering continued surveillance against cancer recurrence.
Reduced Need for Chemotherapy – CAR-T therapy directly targets cancer cells, potentially eliminating the need for extensive chemotherapy and radiation.

Challenges of CAR-T Cell Therapy

Limited Success in Solid Tumors – Unlike blood cancers, CAR-T therapy faces challenges in treating solid tumors due to the tumor’s protective environment.
Severe Side Effects – Patients may develop Cytokine Release Syndrome (CRS) and Neurotoxicity, which can cause life-threatening immune reactions.
High Cost & Limited Accessibility – The therapy is extremely expensive, costing hundreds of thousands of dollars, making it inaccessible to many patients.
Time-Consuming Process – The treatment involves extracting, modifying, and multiplying T cells, which can take several weeks, delaying treatment for critically ill patients.
Potential for Relapse – If cancer cells mutate or stop expressing the targeted antigen, CAR-T cells may become ineffective.

Future Prospects and Research

The researchers at Tata Memorial Centre and IIT Bombay are now exploring the possibility of testing CAR T-cell therapy in earlier stages of treatment and in combination with other immunotherapies.
Ongoing trials aim to refine the therapy and expand its applicability to a broader patient population.

Indian Government’s Initiatives for Cancer Control

Initiative	Key Features	Objective
National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS)	Focuses on cancer prevention, screening, early detection, and treatment; strengthens healthcare infrastructure	Reduce cancer burden through early diagnosis and improved healthcare access
National Cancer Grid (NCG)	A network of 270+ cancer centers ensuring standardized and affordable treatment; promotes research and training	Improve quality and uniformity in cancer care across India
Cervical Cancer Vaccination Initiative (Interim Budget 2024-25)	Encourages vaccination for girls (9–14 years) to prevent HPV-related cervical cancer	Reduce cervical cancer incidence through early immunization

Conclusion

The development of CAR T-cell therapy in India is a groundbreaking achievement in the field of oncology.
With its high efficacy, manageable safety profile, and significantly reduced cost compared to global counterparts, this innovation addresses a crucial unmet need for cancer patients in India. Continued research and trials will further determine its long-term impact, paving the way for more accessible and effective cancer treatments in the country.