Doctors at AIIMS, Delhi, are working on a cost-effective antibody-based adaptive cellular therapy for treating multiple myeloma, a form of blood cancer. This innovative approach aims to make advanced treatments like CAR-T cell therapy more affordable and accessible for patients in India.

CAR-T cell therapy is a form of adaptive cellular therapy where a patient’s T cells are isolated, genetically modified, and reintroduced into the body. These modified cells are programmed to recognize and destroy cancer cells. Dr Mayank Singh, an Additional Professor in the Department of Medical Oncology at Dr B.R. Ambedkar Institute Rotary Cancer Hospital (BRAIRCH), AIIMS, explains, “The therapy focuses on targeting B-cell maturation antigen (BCMA), a tumour-specific protein found in multiple myeloma cells.”

The AIIMS-developed therapy employs BCMA as a target to identify and eliminate multiple myeloma cells. While still in the experimental phase, the therapy has shown promising results in animal models. “Our next step is to initiate phase-1 clinical trials to gather evidence on its safety and efficacy,” Dr. Singh said. He emphasized the aim to significantly reduce the cost of this therapy compared to existing CAR-T cell treatments, which remain prohibitively expensive for most patients in India.

What Is Multiple Myeloma?

Multiple myeloma is a cancer of plasma cells, a type of white blood cell responsible for producing antibodies to fight infections. When these cells become cancerous, they multiply uncontrollably, crowding out healthy blood-forming cells in the bone marrow. This condition is notorious for its high relapse rate, making effective and affordable treatments essential.

Traditional cancer treatments, such as chemotherapy and radiotherapy, target rapidly dividing cells, but they often harm normal cells, leading to severe side effects and even fatal outcomes. Over the past two decades, targeted therapies have emerged, exploiting specific vulnerabilities in cancer cells. However, these treatments often encounter resistance, resulting in relapse.

The Role of Immunotherapy

The last decade has witnessed significant advancements in immunotherapy, including the development of monoclonal antibodies to target cancer cells. These therapies often involve loading antibodies with chemotherapeutic drugs for targeted delivery, minimizing off-target effects and enhancing efficacy.

“Antibody-based therapies have revolutionized cancer treatment, including the creation of cellular CAR-T cell therapies that incorporate components of these antibodies to target antigens on cancer cells,” Dr. Singh noted. However, the high cost of these therapies makes them inaccessible to many, particularly in countries like India.

Cancer in India: A Growing Burden

According to the National Cancer Registry, India recorded an estimated 14,61,427 new cancer cases in 2022. The lifetime risk of developing cancer is one in nine for Indians. The combination of delayed diagnosis and limited access to advanced therapies is expected to exacerbate the country’s cancer burden in the coming years.

“Immunotherapies have the potential to transform cancer treatment, but their high cost limits their reach. Our work at AIIMS is focused on addressing this gap by developing affordable alternatives,” Dr. Singh said.

Progress and Future Plans

The AIIMS research team, led by Dr Singh, has filed an Indian patent for their antibody and is in the process of filing a patent for their CAR-T cell therapy. “The development of CAR-T cell therapy in India is still in its infancy, despite its rapid global adoption. Our work aims to bridge this gap,” Dr Singh said.

As the therapy moves closer to clinical trials, the researchers are optimistic about its potential to revolutionize cancer treatment in India. By making cutting-edge therapies more accessible, they hope to improve outcomes for countless patients battling multiple myeloma and other forms of cancer.

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