Hotchandani Hema, Sengar Manju, Shetty Alok, John Anupa, Karulkar Atharva, Kalra Devanshi, Ravikumar Smrithi, Jaiswal Anjali, Yadav Yuktam, Parkar Sugandha, Walawalkar Anuradha, Kadam Sonali, Bagal Bhausaheb, Nayak Lingaraj, Purwar Rahul, Jain Hasmukh
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
ImmunoAdoptive Cell Therapy Private Limited (ImmunoACT Pvt Ltd), Mumbai, India.
Expert Rev Anticancer Ther. 2025 Jun;25(6):599-608. doi: 10.1080/14737140.2025.2501744. Epub 2025 May 8.
CAR-T cell therapy has changed the treatment paradigm for hematological malignancies, offering a curative potential for patients with relapsed or refractory disease. India, with its significant burden of hematological malignancies, faces unique challenges in implementing this therapy. The development of indigenous CAR-T cells has reduced costs substantially, but barriers remain, including limited manufacturing capacity, relatively high costs, and logistical constraints.
This article emphasizes the importance of optimized patient selection and triaging of apheresis slots to maximize the benefits of CAR-T cell therapy. The use of efficient bridging therapies and antibody-based approaches are being explored to improve outcomes, particularly in aggressive lymphomas and leukemias. Opportunities lie in leveraging India's growing biotechnology sector for cost-efficient production and in evaluating novel combination therapies to enhance CAR-T cell efficacy. This article also explores the technical and socioeconomic challenges of CAR-T cell development in India and suggests strategies to enhance accessibility, affordability, and implementation.
Ongoing advancements and research may help tailor CAR-T cell protocols to the local population. Future integration of NK cell therapy, TCR-based approaches, and multi-antigen targeting holds promise for enhancing therapeutic efficacy.
嵌合抗原受体T细胞(CAR-T)疗法改变了血液系统恶性肿瘤的治疗模式,为复发或难治性疾病患者提供了治愈的潜力。印度血液系统恶性肿瘤负担沉重,在实施这种疗法方面面临独特挑战。本土CAR-T细胞的研发大幅降低了成本,但障碍依然存在,包括生产能力有限、成本相对较高以及后勤限制。
本文强调优化患者选择和单采时段分流以最大化CAR-T细胞疗法益处的重要性。正在探索使用高效的桥接疗法和基于抗体的方法来改善治疗结果,尤其是在侵袭性淋巴瘤和白血病中。机会在于利用印度不断发展的生物技术部门进行具有成本效益的生产,以及评估新型联合疗法以提高CAR-T细胞疗效。本文还探讨了印度CAR-T细胞研发的技术和社会经济挑战,并提出提高可及性、可负担性和实施的策略。
正在进行的进展和研究可能有助于使CAR-T细胞方案适应当地人群。未来将自然杀伤细胞疗法、基于T细胞受体的方法和多抗原靶向相结合有望提高治疗效果。