Cancer, a life-threatening disease, affects millions of people every year. Damage to genes in a particular section of a cell’s DNA causes cancer. Usually, the human body has a mechanism to get rid of damaged or older cells, but at times, these cells escape the body’s defence mechanism and start growing uncontrollably or abnormally, forming a tumour mass, which we call cancer. The awareness about ailment is not enough, and cancer cure remains unaffordable and inaccessible to most people globally, even more so in India. Few ways to treat cancer include surgery, radiation or chemotherapy. Most cancer treatments are expensive, and recovery is not guaranteed.
Prof Rahul Purwar, Atharva Karulkar and Alka Dwivedi from the Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, have developed a new cancer treatment technology called CAR T-cells (Chimeric Antigen Receptor T-cells) therapy. It is used in developed countries but is extremely expensive, needing a few crores of rupees. This made-in-India CAR-T cell therapy developed by IIT Bombay and SINE (Society for Innovation and Entrepreneurship, Business incubator at IIT Bombay) can make the treatment available at a much lesser cost of about ₹15 lakhs.
“CAR T-cells are gene therapy products for the cancer cure, mainly blood cancer, which can be scaled up or validated to treat solid tumours to save suffering lives who otherwise do not opt for treatment in countries like India, with insufficient resources,” says Prof Purwar.
CAR-T cell therapy can treat certain types of leukaemia and lymphoma; however, this first in India project is currently in early clinical trials and provides an end to end indigenous solution for gene therapy. Clinical trials for this therapy are going on in the Tata memorial hospital.
Specialised killer cells, called ‘T-cells’, in the human immune system protect our body from cancer and other diseases. They can recognise tumours and cancerous growths destroy them. In advanced stages, cancer cells can inactivate T-cells or modify themselves in a way that T-cells cannot detect them. A new approach in immunotherapy, called CAR T-cell therapy, restores the ability of the T-cells to recognise the cancer cells and kill them.
Chimeric Antigen Receptors or CARs assist the T-cells in recognising and attaching to a specific protein, or antigen, present on cancer cells. The interaction between these two proteins leads to the destruction of the cancer cell.
The CAR T-cells are popularly called ‘living drugs’ as T-cells are living cells, and they stay in the body forever. They are engineered from the patient’s T-cells. The therapy involves drawing blood from a patient and separating the T-cells, which are then genetically engineered with the help of a non-pathogenic virus to produce CARs. The cells, which can now recognise the antigen on cancer cells and destroy them, are then reintroduced into the patient’s bloodstream.
The patient’s immune cells are collected from their blood using specifically designed magnetic beads. These cells are further grown in incubators for 6 to 7 days and manipulated genetically to make CAR-T cells. The team tests for the safety and purity of the cells. Since they are to be infused into the patient’s body, it is important to ensure purity and safety. Once the cells are ready, they are transferred into larger bag sizes to grow them to clinically meaningful numbers. Later they are preserved in liquid nitrogen tanks for long term storage before infusion.
Lentivirus is a non-pathogenic virus used to genetically engineer the CAR T-cells. The lentivirus to make CAR-T cells also goes through extensive quality and safety tests.
Immunoact, a company incubated in IIT Bombay, is providing CAR-T cell therapy services commercially. After the ongoing clinical trials are through, they will be able to market the CAR-T cell product at an affordable price. CAR-T cell product is patented and has undergone extensive preclinical characterisation and scale-up.
The indigenous CAR-T cell product holds the promise to provide affordable cancer cure for Indian cancer patients.
Editor’s Note: This is part of the special lab stories feature we are bringing to you.