In many cases, CAR T-cell therapy is a "one-and-done" treatment

Dr Sattva S. Neelapu is a leading global expert in advanced cancer treatment methods like CAR T-cell therapy, which is transforming cancer care.

- By Nirmal Jovial

He spoke to THE WEEK on the sidelines of Cura Immunis, a national conclave on CAR-T cell therapy held at the Medical Trust Hospital in Kochi. Excerpts:

Q/ Could you explain the science behind the CAR T-cell therapy?

A/ CAR T-cell therapy is a form of genetically engineered T-cell therapy. The goal is to harness the power of the immune system to treat cancer.

We begin by harvesting T cells, which are a type of immune cell in the body. Then, using a virus as a vehicle, we introduce an artificial receptor into these T cells.

This artificial receptor functions like a heat-seeking device—it is designed to recognise a specific molecule found on the surface of cancer cells.

Once the modified T cell encounters a cancer cell carrying that target molecule, the receptor activates the T cell. This triggers the T cell to attack and kill the tumour cell.

In that sense, it is often referred to as a “living drug”. After we infuse these modified cells back into the patient, they can multiply into billions and travel throughout the body to hunt down and destroy cancer cells.

Q/ What advantages does this therapy offer compared with traditional treatments like chemotherapy or radiation? With chemotherapy, for instance, it is more or less like 'carpet-bombing’. How is CAR T-cell therapy different?

A/ Right. So, this therapy was initially approved for use in patients who had already failed standard treatments, including chemotherapy and radiation—especially in cases like lymphomas and leukaemia. It is considered a completely different modality—this is immunotherapy.