CAR-T Cell Therapy: A Breakthrough in Cancer Immunotherapy

What Is CAR-T Cell Therapy?

CAR T-cell therapy is an advanced form of immunotherapy used to treat certain blood cancers. It involves modifying a patient’s T lymphocytes (T cells) to enhance their ability to identify and destroy cancer cells with this blood cancer therapy. By inserting a specially designed gene into these cells, they are reprogrammed to better recognize and attack malignant cells. In some cases, this therapy may eliminate cancer, while in others, it can extend survival and improve quality of life.

Types of Approved CAR T-cell Therapies

The FDA has approved several CAR T-cell therapies to treat certain leukemias, lymphomas, and multiple myeloma, typically after other treatments have failed. Therapies that have gained FDA approval under the CAR T-cell category include:

Idecabtagene vicleucel (Abecma) – Approved for relapsed or refractory multiple myeloma.
Axicabtagene ciloleucel (Yescarta) – Used in certain types of lymphoma.
Lisocabtagene maraleucel (Breyanzi) – Used as a treatment option for certain types of lymphomas.
Tisagenlecleucel (Kymriah) – Approved for certain pediatric and adult B-cell acute lymphoblastic leukemia (ALL) and some other lymphomas.
Ciltacabtagene autoleucel (Carvykti)- Approved for multiple myeloma treatment.
Brexucabtagene autoleucel (Tecartus)- Indicated for mantle cell lymphoma and B-cell ALL.
Obecabtagene autoleucel (Aucatzyl)- Gained regulatory approval for treating adult B-cell ALL.
Varnimcabtagene autoleucel (Qartemi) – This newly approved CAR T-cell therapy is used for relapsed/refractory B-cell non-Hodgkin lymphoma cases.
Actalycabtagene autoleucel (NexCAR19)- Approved in India for advanced lymphoma and leukemia, developed indigenously with international collaboration.

Fig. 1: FDA-approved CAR T-cell Therapies

When Is CAR T-Cell Therapy Recommended?

CAR T-cell therapy is recommended when certain blood cancers relapse or become resistant to conventional treatments, for example:

B-cell ALL
Primary mediastinal large B-cell lymphoma
Diffuse large B-cell lymphoma (DLBCL)
Mantle cell lymphoma
Follicular lymphoma
Multiple myeloma
High-grade B-cell lymphoma

What to Expect Before, During, and After CAR T-Cell Therapy

CAR T-cell therapy begins with leukapheresis, a procedure that collects your white blood cells using a special machine. These cells are then sent to a laboratory for genetic modification, which takes about three to six weeks. During this period, the individual may receive bridging therapy, such as chemotherapy or radiation to keep the cancer under control.

Before receiving the modified cells, you will undergo lymphodepleting chemotherapy (using chemotherapy to deplete lymphocytes) to help your body accept the modified cells. The CAR T-cell infusion is a short, IV-based procedure, often completed in under 30 minutes, and may require a brief hospital stay.

After treatment, a hospital stay of 7–10 days may be needed to ensure you are recovering well. For the next month, it is important to stay close to your treatment center for regular checkups. You will need a 24-hour caretaker and will be asked to avoid certain activities for up to two months.

The Benefits of CAR T-Cell Therapy

CAR T-cell therapy offers several powerful advantages, particularly for patients with relapsed or treatment-resistant blood cancers. Its unique approach offers the following key benefits:

Single-dose treatment
Short hospital stays
Faster recovery
Long-term remission potential
Bridge to stem cell transplant
Continued cancer surveillance
Effective in aggressive cancers

Fig. 2: Advantages of CAR T-cell Therapy

Future-Driven Systems Supporting CAR T-Cell Therapies

As part of India’s future-driven approach, Qartemi, a CD19-targeted CAR T-cell therapy developed by Immuneel Therapeutics, represents a significant advancement in personalized cancer care.6 Approved for relapsed or refractory B-cell non-Hodgkin lymphoma following the Phase 2 IMAGINE trial, it demonstrated high response rates and is priced at around 50 lakh, far more accessible than global CAR T therapies.
Qartemi is now available at leading Indian hospitals, reflecting the nation’s commitment to accessible innovation. Additionally, NexCAR19, India’s first indigenously developed CAR T-cell therapy by ImmunoACT, has received CDSCO approval and offers a safer, more affordable option for relapsed B-cell lymphomas. Priced at approximately ₹43.2 lakh, it further expands access to advanced therapies in the Indian healthcare system. Supporting these development, India’s I-DRONE initiative facilitates rapid delivery of medical supplies to remote areas, further strengthening the CAR T-cell therapy ecosystem.

Conclusion

CAR T-cell therapy signifies a significant breakthrough in oncology, particularly for those with blood cancers unresponsive to standard treatments. With several FDA-approved therapies available and innovative homegrown options like Qartemi gaining ground, access to this cutting-edge treatment is expanding. India’s commitment to making CAR T-cell therapy more accessible, backed by initiatives like I-DRONE and the development of affordable, globally benchmarked therapies, highlights a promising future for personalized medicine. Ongoing improvements in medical technology, support systems, and regulatory frameworks are enabling CAR T-cell therapy to redefine outcomes in blood cancers and potentially broader indications. With both Qartemi and NexCAR19, India now stands as a global leader in affordable CAR T-cell innovation. These advances are not just scientific milestones, but a shift toward equity and access in cancer care, potentially shaping models for other low- and middle-income countries.

Summary

CAR T-cell therapy is a cancer treatment that reprograms a patient’s T cells to target and destroy cancer cells.
It is primarily used in treating relapsed or refractory hematologic cancers such as B-cell non-Hodgkin’s lymphoma, ALL, and multiple myeloma.
Multiple FDA-approved CART therapies are approved globally, including Yescarta, Kymriah, Tecartus, and Abecma.
India has introduced indigenously developed CAR T therapies, such as NexCAR19 and Qartemi (varnimcabtagene autoleucel).
Qartemi is India’s second approved CAR T-cell therapy, benchmarked to international standards.
Future-driven strategies, including affordability, indigenous innovation, and supportive infrastructure, are expanding CAR T-cell access in India.