The first allogeneic CAR-T therapy procedure was performed by oncologist Dr. Vijay Patil at PD Hinduja Hospital. This advanced therapy involves obtaining T-cells from a donor and infusing them into a patient, marking a major step forward in cancer treatment options for solid organ tumors.
Since the allogeneic CAR-T cells are not yet prepared in India, we had to import them and ensure that they were carefully transported while maintaining a constant temperature of -80 degrees Celsius. After the successful completion of this procedure, we are now looking forward to offering this cutting-edge treatment to hundreds of other such patients in India. The CAR T-cell therapies presently approved by the US FDA and our homegrown NexCar 19 only work against the cancers that have specific ‘locks’ or antigens, such as CD19 and BCMA.Dr. Vijay Patil, Oncologist, PD Hinduja Hospital
Currently, CAR-T therapy is primarily available for certain forms of blood cancer. This is due to the approval of an indigenously developed CAR-T therapy innovation, NexCar-19, by ImmunoACT. However, the successful implementation of an allogeneic CAR-T procedure improves the potential applications of this therapy.
Dr. Patil explained that since allogeneic CAR-T cells are not yet produced in India, they had to be imported. The cells required careful transportation, maintaining a constant temperature of -80 degrees Celsius to ensure their viability. The success of this procedure paves the way for providing this treatment to many more patients in India.
CAR-T therapy is an innovative approach to cancer treatment, utilizing genetically modified T-cells to target and destroy cancer cells in the patient's body. Traditionally, CAR-T cell therapies approved by the US FDA, as well as the homegrown NexCar-19, have been effective against cancers that present specific antigens, such as CD19 and BCMA.
Dr. Patil noticed that current CAR-T therapies are restricted to using the patient's own T-cells (autologous) or those from HLA-matched donors to avoid life-threatening complications such as graft-versus-host disease (GvHD). This complication arises when infused T-cells from an HLA-mismatched donor attack the patient's tissues.
To address these challenges, the innovative procedure performed in Mumbai utilized γδ (Gamma-Delta) T-cells. Unlike traditional αβ (Alpha-Beta) T-cells, which require a precise match to specific antigens, γδ T-cells function as a "master key." They have the capacity to identify a broad range of antigens, destroy cancer cells directly, and trigger a potent immune reaction by releasing pro-inflammatory chemicals known as cytokines. This response recruits other immune cells, including αβ T-cells, enhancing the overall effectiveness of the treatment.
Dr. Patil emphasized the potential of γδ T-cells to change CAR-T therapy. Their ability to recognize various antigens and activate other immune cells makes them a powerful tool in the fight against cancer. The successful completion of this allogeneic CAR-T therapy procedure represents a significant advancement in India’s cancer treatment capabilities and opens up new avenues for patients with solid organ tumors who previously had limited treatment options.
These adoptive cellular immunotherapies are therefore also restricted to using only the patient’s own (autologous) αβ (Alpha-Beta) T-cells, or those of HLA (human leukocyte antigen)-matched donors. If infused in an HLA-mismatched patient, they can potentially lead to a life-threatening graft-versus-host disease (GvHD). To circumvent these challenges, for the first time in India, an allogenic procedure was performed using γδ (Gamma-Delta) T-cells, which are a ‘master key’ possessing the capacity to recognise a wide array of antigens, and activating direct killing mechanisms by bursting the cancer cells, also leading to the secretion of proinflammatory molecules known as cytokines, which leads to a further cascade of immune response recruiting other cells, including the αβ (Alpha-Beta) T-cellsDr. Vijay Patil, Oncologist, PD Hinduja Hospital
With this accomplishment, India has become one of the nations leading the way in developing innovative cancer treatments. More developments and increased accessibility to CAR-T therapy in the nation are expected by the medical community, as Dr. Patil and his colleagues look forward to presenting this innovative treatment to more patients.
(Input from various sources)
(Rehash/ Susmita Bhandary/MSM)