CAR T-cell therapy is a novel form of immunotherapy that has revolutionised cancer treatment. It harnesses the power of the body's immune system to target and destroy cancer cells.

CAR T Cell Therapy

What is CAR T-Cell Therapy?

CAR T-cell therapy, or chimeric antigen receptor T-cell therapy, is a type of immunotherapy that involves reprogramming a patient's own T cells to recognize and attack cancer cells. T cells are a type of white blood cell that plays a crucial role in the immune system's response to infections and diseases. In CAR T-cell therapy, T cells are extracted from the patient's blood, genetically engineered to express chimeric antigen receptors (CARs), and then infused back into the patient's body.

How Does CAR T-Cell Therapy Work?

The process begins with leukapheresis which is a process that involves the collection of a patient's white blood cells- in this case specifically T cells. These T cells are then transported to a laboratory, where they are genetically modified to produce CARs on the surface. CARs are synthetic receptors that enable T cells to recognize specific proteins on the surface of cancer cells known as antigens.

These cells are then multiplied in the laboratory to create a large population of CAR T cells. Finally, the CAR T cells are infused back into the patient's bloodstream, where they can locate and destroy cancer cells that express the corresponding antigen.

Benefits of CAR T-Cell Therapy

It is a highly targeted approach that specifically targets cancer cells while sparing healthy cells, which can reduce the risk of side effects commonly associated with chemotherapy and radiation therapy. Additionally, CAR T-cell therapy has shown remarkable efficacy in treating certain types of cancer, including certain forms of leukaemia and lymphoma, even in patients who have not responded to other treatments.

Furthermore, CAR T-cell therapy has the potential to provide long-lasting remission or even cure in some patients. Unlike traditional treatments that may require ongoing therapy, a single infusion of CAR T cells can lead to long-term anti-cancer activity.

Potential Side Effects

While highly effective, CAR T cell therapy can also cause side effects, some of which can be severe. One of the most common side effects is cytokine release syndrome (CRS), which occurs when the infused CAR T cells become activated and release large amounts of cytokines, triggering an inflammatory response in the body. Symptoms of CRS can range from mild flu-like symptoms to more severe complications such as high fever, low blood pressure, and organ dysfunction.

Another potential side effect of CAR T-cell therapy is neurotoxicity, which can cause confusion, seizures, and other neurological symptoms. These side effects typically occur within the first few weeks after treatment and are usually reversible with appropriate medical management. Other potential side effects of CAR T-cell therapy may include cytopenias (low blood cell counts), infections, and infusion-related reactions. It's important for patients undergoing CAR T-cell therapy to be closely monitored for any signs of side effects, and prompt medical intervention may be necessary if complications arise.

This makes it crucial for CAR T-cell therapy to be administered by professionals with a comprehensive understanding and experience in the field. Dr. Vijay Patil with his 16 years of experience at Tata Memorial Hospital has been a pioneer in introducing and improving CAR T cell therapy treatment in India.

The Future of CAR T-Cell Therapy

CAR T-cell therapy represents a promising advance in the field of cancer treatment, and ongoing research is focused on expanding its applicability to other types of cancer and improving its safety and efficacy. Clinical trials are underway to evaluate CAR T-cell therapy in various solid tumours, including breast cancer, lung cancer, and pancreatic cancer.

It offers the potential for significant benefits, including durable remissions and even cure. The risk of potentially serious side effects can be mitigated by effective management by experienced healthcare professionals. By understanding how CAR T-cell therapy works and its potential risks and benefits, patients can make informed decisions about their treatment options and participate in the ongoing advancement of cancer care.

Gamma Delta T cell

Gamma Delta T-Cell Therapy: A Promising Frontier in Cancer Treatment

Introduction

Gamma delta T-cell therapy is an innovative approach in cancer treatment that leverages the unique properties of gamma delta T cells to target and eliminate cancer cells.

Understanding Gamma Delta T Cells

Gamma delta T cells are a subset of T cells that possess distinctive characteristics compared to conventional alpha beta T cells. Alpha-beta T cells recognize antigens presented by major histocompatibility complex (MHC) molecules somewhat analogous to a lock and key mechanism- with a unique key to every lock. This limits the applicability of these CAR T cells (keys) to only certain types of cancer that express the specific antigens (locks). Gamma delta T cells, on the other hand, work like a master key with the ability to recognize a broader range of antigens, including stress-induced molecules expressed by cancer cells. This unique ability allows gamma delta T cells to directly identify and attack all cancer cells, making them an attractive candidate for cancer immunotherapy.

How Gamma Delta T-Cell Therapy Works

Gamma delta T-cell therapy involves harnessing the power of gamma delta T cells to target and destroy cancer cells. The process begins with isolating gamma delta T cells from the donor's blood then these gamma delta T cells are multiplied and ‘activated’ in the laboratory to enhance their anti-cancer properties.

Once the gamma delta T cells are primed, they are infused back into the patient's bloodstream, where they can migrate to the tumour site and exert their anti-tumor effects. Gamma delta T cells recognize and engage with cancer cells through various mechanisms, including the recognition of stress-induced molecules on the surface of cancer cells and the release of cytotoxic molecules to induce cancer cell death.

Benefits of Gamma Delta T-Cell Therapy

Gamma delta T-cell therapy offers several potential benefits in the treatment of cancer. One key advantage is the ability of gamma delta T cells to target a wide range of cancer types, including solid tumours, without the need for tumour-specific antigens. This broad specificity makes gamma delta T-cell therapy a promising option for patients with various types of cancer, including those with advanced or treatment-resistant disease.

Furthermore, gamma delta T cells possess intrinsic memory and can persist in the body long-term, providing ongoing surveillance and protection against cancer recurrence. This durable anti-tumour response is a desirable feature of gamma delta T-cell therapy that may lead to prolonged remissions and improved outcomes for patients. Gamma delta T cells can be collected from the patient themselves or from a donor without HLA compatibility matching which makes the process of acquiring the cells considerably faster and more convenient.

Potential Challenges and Future Directions

Further research is needed to elucidate the complex interactions between gamma delta T cells and cancer cells and to optimise the therapeutic efficacy of gamma delta T-cell therapy. Additionally, the development of manufacturing processes for large-scale production of gamma delta T cells and the establishment of standardised protocols for their administration are important considerations for the widespread adoption of gamma delta T-cell therapy in clinical practice.

While gamma delta T-cells are in the investigational phase internationally, we at SunACT Cancer Institute Pvt. Ltd. have been the front-runners in this field bringing this avant-garde therapy to India.

In conclusion, gamma delta T-cell therapy represents a promising frontier in cancer treatment that harnesses the unique properties of gamma delta T cells to target and eliminate cancer cells. While there are still challenges to overcome and expand our understanding of the biology, and its potential applications in cancer therapy, gamma delta T-cell therapy holds the promise of offering new hope to patients with cancer by providing effective and personalised treatment options. You can explore this option with our pioneering experts at SunACT Cancer Institute Pvt. Ltd.

Frequently Ask Questions

CAR T-cell therapy, or chimeric antigen receptor T-cell therapy, is a type of immunotherapy that involves reprogramming a patient's own T cells to recognize and attack cancer cells.

T cells are a type of white blood cell that plays a crucial role in the immune system's response to infections and diseases. In CAR T-cell therapy, T cells are extracted from the patient's blood, genetically engineered to express chimeric antigen receptors (CARs), and then infused back into the patient's body where they can locate and destroy cancer cells that express the corresponding antigen.

It is a highly targeted approach that specifically targets cancer cells while sparing healthy cells, which can reduce the risk of side effects commonly associated with chemotherapy and radiation therapy. Additionally, CAR T-cell therapy has shown remarkable efficacy in treating certain types of cancer, including certain forms of leukemia and lymphoma, even in patients who have not responded to other treatments.

Furthermore, it has the potential to provide long-lasting remission or even cure in some patients. Unlike traditional treatments that may require ongoing therapy, a single infusion of CAR T cells can lead to long-term anti-cancer activity.

While highly effective, CAR T cell therapy can also cause side effects, some of which can be severe.

Two of the most common side effects are

  1. Cytokine release syndrome (CRS), which occurs when the infused CAR T cells become activated and release large amounts of cytokines, triggering an inflammatory response in the body. Symptoms of CRS can range from mild flu-like symptoms to more severe complications such as high fever, low blood pressure, and organ dysfunction.
  2. Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) characterized by confusion, seizures, and other neurological symptoms. These side effects typically occur within the first few weeks after treatment and are usually reversible with appropriate medical management.

Other potential side effects of CAR T-cell therapy may include cytopenias (low blood cell counts), infections, and infusion-related reactions. It's important for patients undergoing CAR T-cell therapy to be closely monitored for any signs of side effects, and prompt medical intervention may be necessary if complications arise.

It can cost anywhere between 40-50 lacs per session. However, certain CAR T cell products have to be imported making their cost higher and also variable per the foreign exchange rates.

Certain insurances cover CAR T cell therapies, while some others do not. It is best to check with your insurance provider while we plan the treatment.

The patient will need to be admitted for at least ____days. The admission maybe prolonged subject to fever, drop in blood counts, etc.

Patients who receive CAR T-cell therapy will need to be monitored closely during the recovery process, which typically lasts around 30 days. During this time, a caregiver must closely watch the patient for signs of infection, fever and neurological changes, all of which can be complications of receiving this form of cancer treatment. Fatigue and loss of appetite are to be expected during the recovery process. Patients recovering from CAR T-cell therapy will be instructed to rest and take things slowly in the weeks following their treatment.

6 different CAR T cell therapy products are approved by the US FDA which work against 2 specific targets- CD19 and BCMA mainly for use in leukemias, lymphomas, and multiple myeloma.

In October 2023, NexCAR19 became India’s first approved CAR-T cell therapy. There are many more products in the pipeline being developed.

There are many clinical trials available in CAR T cell therapy internationally as well as at SunACT Institute. We also have clinical trials for CAR T cell therapies in solid tumors and well as in blood cancers.

Gamma delta T-cell therapy is an innovative approach in cancer treatment that leverages the unique properties of gamma delta T cells to target and eliminate cancer cells.

  1. Gamma delta T cells are a subset of T cells that possess distinctive characteristics compared to conventional alpha beta T cells. Alpha-beta T cells recognize antigens presented by major histocompatibility complex (MHC) molecules somewhat analogous to a lock and key mechanism- with a unique key to every lock. This limits the applicability of these CAR T cells (keys) to only certain types of cancer that express the specific antigens (locks). Gamma delta T cells, on the other hand, work like a master key with the ability to recognize a broader range of antigens, including stress-induced molecules expressed by cancer cells. This unique ability allows gamma delta T cells to directly identify and attack all cancer cells, making them an attractive candidate for cancer immunotherapy.
  2. Gamma delta T cells possess intrinsic memory and can persist in the body long-term, providing ongoing surveillance and protection against cancer recurrence. This durable anti-tumor response is a desirable feature of gamma delta T-cell therapy that may lead to prolonged remissions and improved outcomes for patients.
  3. Gamma delta T cells can be collected from the patient themselves or from a donor without HLA compatibility matching which makes the process of acquiring the cells considerably faster and more convenient.

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