A mere year ago, Dr. (Col) V K Gupta, aged 64, would have dismissed as mere optimism any suggestion that he would not only be declared “cancer-free” after a failed bone marrow transplant in 2022 but also return to work by 2024. As a former army doctor with 28 years of service, Gupta battled acute lymphoblastic leukaemia, a rapidly progressing cancer affecting white blood cells, specifically lymphocytes.

In November 2023, India’s drug regulator approved CAR-T cell therapy, a groundbreaking treatment offering hope to cancer patients. Gupta, a distinguished gastroenterologist from Delhi and former Indian Army officer, achieved a remarkable milestone on February 7 at Tata Memorial Hospital. He became the first patient to be declared “currently free of cancer cells” following the procedure at the hospital.

Thanks to a groundbreaking therapy developed by ImmunoAct, IIT Bombay, and Tata Memorial Hospital, Gupta found himself among the fortunate beneficiaries. This innovative treatment, administered to 15 patients in India, resulted in remission for three individuals, including Gupta. His decision to undergo this life-saving therapy, though financially significant at Rs 42 lakh ($50,000), proved far more feasible than the approximate Rs 4 crore ($480,000) cost of similar treatments abroad.

Under the care of doctors at Tata Memorial Hospital, Gupta became the first commercial patient to achieve a cancer-free status following the therapy. His success signifies a remarkable advancement in cancer treatment within India. CAR-T cell therapy, a cutting-edge method, has transformed the approach to combatting certain cancers by genetically modifying a patient’s immune cells, known as T cells, to target cancer cells effectively.

In Gupta’s case, CAR-T cell therapy was employed to tackle multiple myeloma, a rare form of blood cancer affecting plasma cells in the bone marrow. Conventional methods often struggle to address this type of cancer, making CAR-T cell therapy a beacon of hope.

Dr Hasmukh Jain, a hemato-oncologist and associate professor at the Advanced Centre for Treatment, Research, and Education in Cancer (ACTREC), Tata Memorial Centre, cautioned against prematurely claiming a lifelong cure but acknowledged Gupta’s current cancer-free status.

CAR-T cell therapy begins by extracting T cells from the patient’s blood and genetically modifying them in the lab to express a receptor known as the chimeric antigen receptor (CAR). This modification allows the T cells to recognize and bind to specific proteins on the surface of cancer cells. Once infused back into the patient, these enhanced T cells can effectively identify and destroy cancer cells, potentially leading to remission or even a cure.

The success of Gupta’s treatment underscores the vast potential of CAR-T cell therapy in revolutionizing cancer treatment, offering hope to patients with otherwise resistant cancers such as leukaemia, lymphoma, and multiple myeloma.

While clinical trials have shown impressive response rates, it’s essential to acknowledge potential side effects like cytokine release syndrome (CRS) and neurological toxicity. Laboratory tests and trials on animals showed that homegrown CAR-T cell therapy has significantly fewer side effects than those developed in other countries.

Current treatments might extend a cancer patient’s life by a short while, but innovative therapies such as CAR-T aim to deliver a cure and lasting advantages. With CAR-T, treatment becomes simpler as it involves a one-time therapy, unlike the multiple chemotherapy sessions. However, the therapy is not yet effective for all types of cancer and may not be suitable for all patients.

Researchers continue to explore CAR-T cell therapy’s potential in treating solid tumours, although challenges persist in identifying suitable targets and overcoming the immunosuppressive environment typical of these cancers. Nonetheless, CAR-T cell therapy represents a promising frontier in cancer treatment, providing renewed optimism for patients facing resistant forms of the disease.