NexCAR19 is a medical concept and a specific type of Chimeric Antigen Receptor (CAR) T-cell therapy, which is a cutting-edge form of immunotherapy. It is India's first indigenously developed CAR T-cell therapy, also known by its generic name, talicabtagene autoleucel. The therapy originated from a collaboration between researchers at the Indian Institute of Technology (IIT) Bombay and the Tata Memorial Hospital (TMH), with its development supported by the Department of Biotechnology (DBT) and the Biotechnology Industry Research Assistance Council (BIRAC).
The therapy was created to solve the problem of high cost and limited access to advanced cancer treatment, as international CAR T-cell therapies can cost around $400,000, while NexCAR19 is priced at approximately ₹40 lakh ($50,000). It was approved by the Central Drugs Standard Control Organization (CDSCO) in October 2023 for the treatment of relapsed or refractory B-cell lymphomas and B-cell acute lymphoblastic leukemia (B-ALL) in patients aged 15 and above.
NexCAR19 works by being a personalized treatment that uses the patient's own immune cells. First, T-cells are collected from the patient's blood, then genetically modified in a laboratory to express a Chimeric Antigen Receptor (CAR) that specifically targets the CD19 protein found on the surface of cancerous B-cells. These modified cells are multiplied and then re-infused into the patient, where they act as a "living drug" to identify and destroy the cancer cells. Clinical trials involving 64 patients showed that 67% experienced a significant decrease in cancer, with about half achieving complete remission. NexCAR19 is considered a humanized CAR T-cell therapy, which has been associated with fewer severe side effects compared to some US-approved therapies. It connects to the broader field of gene therapy and positions India among a select group of nations with an indigenous CAR T-cell platform.