More investments needed in clinical trials for CAR-T cell therapies to tackle cancer, says Carl June 

June says India can help make CAR-T cell therapies more broad based and accessible. “The way India has worked on bone marrow transplantation that they have been able to do much more cheaper than the US but with just the same efficacy can come in handy.” Medical infrastructure will support CAR-T cell therapy trials. “What’s needed now is investment from venture capitalists, philanthropy, government investment and incentives, rest is all here in India,” he observed.

June, a professor at the University of Pennsylvania, led the pioneering work to develop cancer treatment where patient's own T-cells are drawn from the blood, isolated and genetically modified to identify, target and kill cancer cells. The antigen tagged to T-cells is chimeric antigen receptor (CAR) and hence the name CAR-T cell therapy.

Currently, CAR-T cell therapy is approved for the treatment of Leukemia and Lymphoma, two forms of blood cancer. Novartis was the first company to commercialise its drug Kymriah, that is being used to treat acute lymphoblastic leukemia (ALL) and Non-Hodgkin lymphoma (NHL). Gilead is also in the market with its CAR-T therapy Yescarta used to treat NHL.

However, the exorbitant cost of the therapy restricts its use on a broad scale.

In the United States where the therapy is approved, it costs about over $1-1.5 million. Kymriah – the CAR-T therapy by Novartis, and Yescarta by Gilead are both priced upwards of $3,75,000.

Dr June says manufacturing cost will come down by almost ten-fold when the therapy production becomes automated with robots. “Currently the most expensive part of making CAR-T is the human labour.”

While the personalised aspect of CAR-T therapy makes it revolutionary, Dr June says in the next few years the science will progress to make it on

He agrees the results may vary.

“We will eventually have both types of CAR-T,” one which will be the personalised therapy, where the patient themselves are the source of the drug. The second will be manufactured on lines, ‘off-the shelf’, that will not last as long in the patient body.

“The first patient we treated with CAR-T therapy in 2010 still has CAR-T cells in the body and it is functioning. So it is a living drug,” June added.

This year one or two US companies are expected to get commercial approval for treating myeloma through CAR-T cell therapies. June anticipates that in the next five years all bone marrow cancers will have CAR-T cell therapies.