CAR‑T Cell Therapy

Can the immune system fight cancer?

Our immune system detects and destroys viruses, bacteria, and foreign invaders because they look "non-self." Cancer is different: cancer cells come from our own body, often look normal, and hide from immune detection. Simply "boosting immunity" through diet, supplements, or lifestyle cannot cure cancer. The immune system needs help recognizing cancer — that's where CAR-T therapy comes in.

What are T cells?

T-cells are the immune system's security guards. They move through the body constantly checking cells. When they find infected or abnormal cells, they activate and destroy them. But cancer cells can disguise themselves and escape detection. CAR-T therapy reprograms T-cells to identify cancer more clearly.

What is CAR-T cell therapy?

CAR-T stands for Chimeric Antigen Receptor T-Cell Therapy. T-cells are taken from the patient's blood, genetically modified in a lab, trained to recognize cancer, and returned to the patient. Once infused, these cells find cancer cells, attach to them, and kill them. They can continue multiplying inside the body — often called a "living drug."

How are CAR-T cells made?

Step 1 — T-cell collection: blood is drawn and T-cells are separated (leukapheresis). Step 2 — Genetic modification: a special gene is added so they recognize a specific protein on cancer cells (transduction). Step 3 — Expansion: modified cells are grown in large numbers. Step 4 — Lymphodepleting chemotherapy: short chemo before infusion to make space for CAR-T cells. Step 5 — Infusion: CAR-T cells are infused back; inside the body they begin targeting cancer cells.

Who needs CAR-T therapy?

Usually considered for: relapsed leukemia, refractory lymphomas, disease returning after transplant, cancers not responding to standard treatments. It is not a first-line therapy in most cases. Patient selection depends on cancer type, disease burden, overall health, and prior treatments.

How long does it take?

Manufacturing time varies: around 3 weeks in India, up to 6 weeks internationally. During this period, doctors may use bridging therapy to keep the disease under control.

Risks and side effects

CAR-T therapy can cause strong immune reactions. Cytokine Release Syndrome (CRS): symptoms may include fever, low blood pressure, breathing difficulty; severe cases can affect organs. Neurological effects: possible confusion, slurred speech, tremors, seizures. Most cases are treatable with steroids and tocilizumab.

What happens after CAR-T?

CAR-T cells may destroy both cancerous and normal B-cells, leading to hypogammaglobulinemia (reduced antibodies, higher infection risk). Management may include preventive antibiotics and IVIG infusions.

How do we know CAR-T is still working?

If B-cells remain absent, it suggests CAR-T cells are still active. Doctors may monitor using PCR testing and blood markers. Relapses usually occur within the first year if they happen.

Different types of CAR-T therapies

Not all CAR-T treatments are the same. They differ in target proteins (CD19, BCMA, etc.), genetic design, and cell source. Each therapy is like a key designed to fit a specific lock. If the cancer does not express that target, the therapy may not work.

Cost of CAR-T therapy

CAR-T therapy is highly personalized. Estimated cost: around ₹50 lakhs in India. Why it's expensive: custom manufacturing for each patient, genetic engineering process, specialized labs, hospital monitoring. This remains one of the biggest barriers to access.

Limitations

CAR-T is not a cure for every cancer. Challenges include: some patients relapse, manufacturing failures, T-cell quality variation, high cost. However, response rates in relapsed leukemia and lymphoma have been very encouraging.

The future

Research is ongoing in solid tumors, universal donor CAR-T cells, safer constructs, and faster manufacturing. CAR-T therapy represents a major shift toward immune-based cancer treatment — but it is still evolving.

Frequently asked questions