NEXCAR19
– SCI & TECH
News:
UPSC Essentials | One
word a day — NexCAR19, the therapy
What's
in the news?
●
The Central Drugs Standard Control
Organisation (CDSCO) this month granted market authorisation for NexCAR19.
●
It is India’s first indigenously-developed
CAR-T cell therapy, to ImmunoACT, a company incubated by IIT Bombay.
NexCAR19
Therapy:
●
NexCAR19 therapy is designed to target cancer cells that carry the CD19
protein. This protein acts like a flag on cancer cells, which allows CAR-T
cells to recognise and attach themselves to the cancer cells and start the
process of elimination.
●
India is now one of the first developing
countries to have its indigenous CAR-T and gene therapy platform.
●
The therapy is for people with B-cell
lymphomas who didn’t respond to standard treatments like chemotherapy, leading
to relapse or recurrence of the cancer.
Go
back to basics:
CAR
T-cell Therapy:
●
Chimeric antigen receptor (CAR) T-cell
therapies represent a quantum leap in the sophistication of cancer treatment.
●
Unlike chemotherapy or immunotherapy,
which require mass-produced injectable or oral medication, CAR T-cell therapies
use a patient’s own cells.
●
They are modified in the laboratory to
activate T-cells, a component of immune cells, to attack tumours.
●
These modified cells are then infused back
into the patient’s bloodstream after conditioning them to multiply more
effectively.
●
The cells are even more specific than targeted agents and directly activate the
patient’s immune system against cancer, making the treatment more clinically effective. This is why
they’re called ‘living drugs’.
How
does it work?
●
In CAR T-cell therapy, the patient’s blood
is drawn to harvest T-cells – immune cells that play a major role in destroying tumour cells.
●
Researchers modify these cells in the
laboratory so that they express specific proteins on their surface, known as
chimeric antigen receptors (CAR) - they have an affinity for proteins on the
surface of tumour cells.
●
This modification in the cellular
structure allows CAR T-cells to effectively bind to the tumour and destroy it.
○
Conventional
chemotherapy or immunotherapy comprises molecules that
bind to the tumour or block chemical pathways that allow the tumour to grow or
multiply – but don’t directly affect the
immune system.
●
In CAR
T-cell therapy, the immune system is activated when the modified T-cells
are reintroduced into the body, which allows a gradual and sustained tumour
kill as these cells multiply.
Applications:
●
As of today, CAR T-cell therapy has been
approved for leukaemias (cancers
arising from the cells that produce white blood cells) and lymphomas (arising from the lymphatic system).
●
CAR T-cell therapy is also presently used
among patients with cancers that have returned after an initial successful
treatment or which haven’t responded to previous combinations of chemotherapy
or immunotherapy.
Response
of CAR T-cell therapy:
●
Its response
rate is variable. In certain kinds of leukaemias and lymphomas, the
efficacy is as high as 90%, whereas in other types of cancers it is
significantly lower.
●
The potential side-effects are also
significant, associated with cytokine
release syndrome (a widespread activation of the immune system and
collateral damage to the body’s normal cells) and neurological symptoms (severe
confusion, seizures, and speech impairment).
●
It is unaffordable to half of the Indians
as it is costly.