CAR-T

In September 2013, Scot McIntyre, 53 years developed a swelling in his right groin area. A month later he got a swollen node in his neck and another under his arm. In November 2013, the diagnosis was confirmed to be lymphoma.

His was one of the most aggressive form of cancer. For the next 18 months, Scot was in and out of hospital every month. He had undergone two counts of chemotherapy, two courses of radiotherapy, two experimental treatments and finally stem cell transplantation: the ultimate treatment available for this type of cancer. But the cancer came back in six months and doctor told him he had only a few months to live.

Dr Sonali Mehta Smith, UChicago who had treated Scot McIntyre.

Then he received a phone call from Dr Sonali Mehta Smith, the Elwood V. Jensen Professor in Medicine and director of University of Chicago Medicine’s lymphoma program for another experimental (but not approved yet ) therapy: the CAR-T.

He had nothing more to lose. He said,”Why not ?”

McIntyre’s medical team took out his blood, extracted the lymphocytes, and returned everything else. These cells are put on ice and were sent to Novartis. In the labs of Novartis, his T cells (a specific type of immune cells) were modified to seek and fight his own cancer cells. B cells and T cells work in a lock and key module. They latch on to their adversary like a key fits inside a lock and won’t release their grip on the adversary. It took about three weeks to retrofit the T cell of Scot McIntyre with codes that would match and fit the cancer cells circulating in his blood. On May 2016, these retrofitted lymphocytes called CAR-T arrived in a metal cooler packed with liquid nitrogen. The lab people removed the small packet of frozen cells and gently began to thaw them. The infusion itself took just 10 minutes as these batch if mercenaries from Scot’s own T cells now secretly trained to fight against his own cancer cells coursed through an iv canal into his body. Once these modified T cells entered his body, each one multiplied rapidly, producing thousands of offspring. Then they would launch a vigorous assault on the cancer cells. As the cancer cells multiplied inside him, so also these fighter T cells and it was an even battle.

…

Since then few unbelievable things happened to Scot McIntyre.

After a few weeks, Scot McIntyre improved enough to watch his favourite soccer team take to field in his favourite Notre Dam football match.
From the football field, he texted a photo of himself to Dr Sonali and wrote: “Because of you, I’m living my dream.” Something like a screenshot from the all time great movie Kal Ho Na Ho.
A few weeks later, the McIntyres’ oldest son wed his longtime fiancée. They had postponed the wedding for years, McIntyre says, “because I kept getting so sick.”
Since then he has gone back to his Truck business.

Every year since, McIntyre has texted Dr Sonali a photo from Notre Dam’s opening day game.

McIntyre was patient 1 to receive this treatment and the procedure that saved him received approval from the Food and Drug Administration in August. UChicago Medicine is one of the first sites in the Midwest certified to provide CAR T-cell therapy.

https://www.uchicagomedicine.org/forefront/cancer-articles/a-walking-miracle-car-t-cell-therapy

Dr Sonali ( Mehta) Smith of Chicago University has selected Scot as her first case.

“Returning a patient from a death bed to a life where he can go to a college football game is the greatest miracle that a doctor can ever dream of.”

This highly specific and promising form of treatment that harnesses the versatile effector machinery of the human immune system, has revolutionized cancer treatment across the world

Indian Scenario

In India two pharmas *Immuneel* and *ImmuACT* are conducting phase 2/3 clinical trial of CAR-T therapy.

If the trials go well, this treatment will be available to Indian public in one more year . That will be a big step forward as India remains as the third highest nation in cancer diagnosis after USA and China.

Conclusion:

Cancer has become the biggest nemesis of humanity. It has not responded to our standard protocol like chemotherapy, radiotherapy and surgical interventions.