Why is News :
- A June 2024 Science journal study proposes a novel in vivo CAR T-cell therapy technique, where genetic reprogramming of immune cells happens directly inside the body—without lab-based cell extraction.
- If successful, this could revolutionize cancer and autoimmune disease treatment, especially in resource-constrained nations like India.
What Is CAR T-Cell Therapy?
- CAR (Chimeric Antigen Receptor) T-cell therapy is a form of immunotherapy that trains T-cells to recognize & destroy cancer cells.
- In the traditional method, T-cells are extracted from the patient, genetically modified in a lab (usually using viral vectors), and reinfused after chemotherapy.
- Used in aggressive blood cancers (e.g. Acute Lymphoblastic Leukemia, Non-Hodgkin Lymphoma) and being explored for autoimmune diseases like lupus.
Limitations of Conventional CAR T-Cell Therapy
- Requires ex vivo processing and custom viral engineering.
- Involves toxic chemotherapy to prepare the immune system.
- Costs ₹60–70 lakh in India, with ~₹35 lakh for cell manufacturing.
- Risk of cytokine storm, neurological effects, and immunodeficiency post-treatment.
The In Vivo Technique (CD8-tLNP Approach)
What’s new?
- mRNA is packaged in CD8-targeted lipid nanoparticles (CD8-tLNP) and injected into the bloodstream.
- These nanoparticles deliver CAR-encoding RNA directly to CD8+ T cells, converting them into cancer-fighting agents inside the body.
Advantages:
- No need for cell extraction or lab modification.
- Avoids viral vectors — reducing long-term genetic risks.
- Bypasses chemotherapy, reducing hospital stays and infection risk.
- Delivery resembles a drug infusion, not complex cell therapy.
Results from Animal Trials
In mice and monkeys, the technique:
- Reprogrammed up to 85–95% of T-cells to target cancer.
- Led to tumour regression and B-cell depletion across organs.
- Used Lipid 829, a biodegradable carrier with low inflammation risk.
Safety Concerns
- Most animals tolerated treatment well with minor inflammation.
- One monkey developed an immune overreaction (HLH), highlighting the need for clinical dose control.
- Human trials are pending to evaluate safety, repeatability, and long-term effects.
Relevance for India
India has a high burden of:
- DLBCL (34–60% of Non-Hodgkin lymphoma cases)
- Acute lymphoblastic leukaemia (75% of childhood cancers)
- Rising autoimmune disorders post-COVID (↑30%)
Current CAR T-cell therapy is:
- Unaffordable for most
- Limited by infrastructure (few cell therapy labs)
In vivo therapy offers:
- Cost reduction
- Scalability for rural/semi-urban India
- Less dependency on advanced infrastructure
Conclusion
This in vivo CAR T-cell breakthrough could democratize access to life-saving immunotherapy, particularly in LMICs like India, by eliminating key bottlenecks of traditional methods. If validated through human trials, it could redefine the future of precision medicine.
| UPSC Relevance : GS Paper 3 – Science & Tech | Health | Biotechnology Possible Mains Question : Q: What are CAR T-cell therapies? Discuss how innovations in in vivo genetic editing can transform healthcare delivery in India. |