Medical issues and perspectives

Narayana Health City in Bangalore has achieved a breakthrough in cancer treatment through the successful application of CAR T-cell therapy, signifying a significant advancement in the battle against cancer. Developed by IMMUNEEL in Bangalore, this state-of-the-art immunotherapy modifies a patient’s T-cells to enhance their ability to identify and combat cancerous cells.

CAR T-cell therapy, also referred to as Chimeric Antigen Receptor T-cell therapy, has demonstrated remarkable effectiveness in addressing specific blood cancers such as leukemia and lymphoma. The procedure involves the genetic modification of T-cells to specifically target and eradicate cancer cells.

Dr. Sharat Damodar, Senior Consultant Haematologist and Head of Adult BMT at Narayana Health City, remarked, “CAR T-Cell therapy has revolutionized cancer treatment by providing a lifeline to patients who have exhausted conventional options.” He highlighted a case illustrating the therapy’s potential to induce lasting remission in relapsed lymphoma.

The recent approval of CAR T-cell therapy by the Drug Controller General of India (DCGI) for commercial use is a significant milestone for patients grappling with relapsed and refractory cancers. Hamza Khan, a 42-year-old resident of Bangalore, became the inaugural patient in South India to undergo this groundbreaking treatment for relapsed follicular lymphoma.

Hamza’s cancer journey commenced during the COVID-19 pandemic in 2020. Despite undergoing multiple chemotherapy rounds and rituximab maintenance, his cancer relapsed in February 2022, leading to a dire prognosis. Standard treatments, including chemotherapy and autologous stem cell transplant, proved futile, exacerbated by a severe COVID-19 infection.

Selected for CAR T-cell therapy in September 2022, Hamza underwent the procedure under the care of Dr. Sharat Damodar, with successful administration in November 2022. Experiencing minimal side effects, Hamza achieved remission, surpassing the significant milestone of one-year post-treatment without relapse.

Narayana Health City continues to lead the charge in such advancements, ensuring that cutting-edge treatment options are accessible within India. The hospital’s Facility Director expressed immense pride in the strides made in cancer treatment, emphasizing their commitment to providing the best care and hope to patients through innovative therapies like CAR T-cell therapy.

A 23-month-old boy named Hridyansh, afflicted with spinal muscular atrophy (SMA), underwent groundbreaking gene therapy at J K Lon Hospital, financed through innovative means. The procedure, costing Rs 17.5 crore, was facilitated by a remarkable crowdfunding effort, spearheaded by Hridyansh’s determined parents, who garnered support from various quarters including the police department and local politicians.

Despite facing a daunting financial hurdle, the family’s relentless pursuit for funds resulted in a successful collaboration with the police force, which donated over Rs 5 crore, along with contributions from other sources. The intervention of the Centre, waiving customs duty on the imported medication, further eased the financial burden, reducing the therapy’s cost to Rs 14.5 crore.

With Rs 9 crore raised through crowdfunding, the family negotiated with the drug manufacturer to cover the remaining cost in installments. This collective effort culminated in Hridyansh receiving the crucial gene therapy, his last hope for treatment, at the critical age of 23 months.

Spinal Muscular Atrophy (SMA) is a genetic disorder characterized by the degeneration of motor neurons, leading to progressive muscle weakness and atrophy. It is caused by a deficiency in the SMN1 gene, crucial for motor neuron survival. SMA affects various aspects of daily life, including movement, breathing, and swallowing, often leading to significant disabilities and reduced life expectancy. Recent advancements in treatments like gene therapy, exemplified by Zolgensma, produced by the renowned Swiss pharmaceutical company Novartis is a groundbreaking gene therapy for spinal muscular atrophy (SMA).

Administered in a single dose, it targets the genetic root of SMA by replacing the missing or nonfunctional SMN1 gene with a functional one, ensuring proper muscle function. Utilizing adeno-associated virus 9 (AAV9) as a vector, ZOLGENSMA is safely delivered to motor neuron cells. Prior to treatment, doctors assess AAV9 antibody levels through a blood test to ensure efficacy. If levels are high, monitoring and retesting may be necessary. Consultation with a healthcare provider is crucial for personalized guidance on your child’s treatment journey.

Dr. Priyanshu Mathur, overseeing rare diseases at J K Lon Hospital, emphasized the therapy’s potential to combat SMA’s debilitating effects, marking a significant advancement in medical intervention for such conditions.