India's first CAR T-cell therapy approved UPSC

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Context: India's first chimeric antigen receptor (CAR) T-cell therapy has been approved for the treatment of relapsed-refractory B-cell lymphoma and leukaemia. CAR T-cell therapy is a type of immunotherapy that uses the patient's immune system to fight cancer.

Details

India's first CAR T-cell therapy for the treatment of relapsed-refractory B-cell lymphoma and leukaemia is a significant milestone for cancer treatment in India.
CAR T-cell therapy is a type of immunotherapy that uses the patient's immune system to fight cancer. T cells are a type of white blood cell that plays a key role in the immune system. CAR T-cell therapy involves engineering the patient's T cells to recognize and attack cancer cells.

How CAR-T Cell Therapy Works

Collection of T-Cells: The process begins with the extraction of a patient's blood. From this blood sample, T-cells, a type of white blood cell with a crucial role in the immune system, are isolated. T-cells are essential for the body's defence against infections and diseases.
Genetic Modification: In the laboratory, T-cells are genetically modified with chimeric antigen receptors (CARs) targeting CD19, a protein present in B lymphocytes, allowing precise recognition and potential destruction of cancerous B-cells in conditions like B-cell leukaemia and lymphoma.
Cell Infusion: After the genetic modification is complete, these engineered T-cells are cultured and multiplied in the lab, producing a large number of CAR-T cells. These CAR-T cells are then collected and prepared for infusion back into the patient's bloodstream.
Targeted Attack: Following infusion, CAR-T cells are programmed to seek out and attach to cells expressing CD19, predominantly cancerous B-cells, as they circulate through the patient's bloodstream and lymphatic system, forming a targeted approach to cancer therapy.

Significance and Implications

High Response Rate	●The 70% overall response rate in patients with relapsed-refractory B-cell lymphomas and leukaemia demonstrates the therapy's effectiveness in treating otherwise difficult-to-treat cases. ●High response rates indicate that this therapy can offer substantial benefits to patients who might not have responded to conventional treatments, potentially leading to improved survival rates and quality of life.
Safety Profile	●NexCAR19's improved safety profile, with reduced cytokine release syndrome (CRS) and absence of neurotoxicity, signifies advancements in managing the side effects associated with CAR-T cell therapy. ●Enhanced safety profiles are crucial for minimizing risks and ensuring that patients can undergo treatment with manageable side effects, leading to a higher quality of care.
Affordability	●The significant reduction in the cost of CAR-T cell therapy, from $400,000 to approximately Rs 30-35 lakh per patient, is a game-changer for healthcare accessibility. ●Lower costs make the therapy more affordable and accessible to a larger population, especially in countries like India where healthcare affordability is a significant concern. ●Affordability ensures that a broader range of patients can benefit from this cutting-edge treatment without financial constraints becoming a barrier to access.
Wider Availability	●Approval by regulatory authorities and the therapy's availability in government and private hospitals across major cities in India greatly expand its accessibility. ●The wider availability of NexCAR19 means that eligible patients do not have to travel abroad to receive treatment, reducing the burden on patients and their families.

Conclusion

NexCAR19 marks a milestone in cancer treatment, providing a precise and affordable therapy for relapsed-refractory B-cell lymphoma and leukaemia in India, elevating patient care quality and positioning India as a frontrunner in CAR-T cell therapy, expanding advanced cancer treatment accessibility.

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PRACTICE QUESTION

Q. What are the key challenges faced by the healthcare system in India, and what strategies are being implemented by the government and healthcare organizations to enhance accessibility, affordability, and the overall quality of healthcare services for the diverse population in the country?