Will CAR T-Cell Therapy Get Cheaper?

Will CAR T-cell therapy become cheaper?

Yes. But that’s not a particularly good article, so let me expand on this answer.

Automating processes

Firstly, if you’ve read the previous article on why chimeric antigen receptor T-cell therapy (CAR T-cell therapy) is so expensive in the first place, you’ll know that it’s a very labor and time-intensive process – well therein also lies one way to make it cheaper. How might we get the same outcome, with less labor or less time?

As machines get better and more can be automated, cell editing will be able to become more automated. I have toured a lab where they do the DNA editing of the T-cells, and they showed me the old machines which required about 30 hours of people’s time to use, and the new ones, which cut that right back to about 30 minutes. As these machines become more widely used, the cost should decrease.

In addition, there are new players coming into the CAR T-cell therapy field, and with competition usually comes cost reduction. Each new pharma company that gets into this sort of treatment brings more smart minds who can look at the process and other improvements, and of course, more customers for the machine manufacturers, bringing their price down also.

Off the shelf treatments?

But the biggest opportunity for reducing cost will come about with making the CAR T-cells generic rather than specific to each individual. As I’ve written in another article, the T-cells I got back when I was treated for my lymphoma were more of my own cells that had been modified, in a long and costly process – but what if the doctor could just grab a bag ‘off the shelf’ and treat me? In the same ways we get blood transfusions today, using bags of donor blood – could we also get bags of donor CAR T-cells?

Theoretically yes – in fact, this is similar to how some forms of stem cell transplants work, the ones called ‘allogeneic stem cells’. But it is complicated. When you get a blood transfusion, the doctors are careful to match your blood type (A, AB, O, etc.) with the donated blood to reduce the chances of your body rejecting the donated blood – it would be similar with the idea of having someone else’s T-cells made into CAR T-cells for you. In fact, even more complex. The introduced CAR T-cells could start attacking healthy cells (called ‘graft-versus-host disease’) or you could develop immune issues.

Moving towards a cancer ‘vaccine’

Theoretically, these issues could be overcome, and as scientists and doctors learn more about CAR T-cell therapy, this to me seems one of the most exciting ways that cost can be reduced, and access expanded. Perhaps one day when you start developing the first symptoms or the first cancer cells are detected, it could be as simple as grabbing a bag of matching CAR T-cells off the shelf and giving you a quick shot to avoid it developing further. Perhaps even more excitingly, you may one day be able to get a shot to prevent you from getting certain types of cancer at all, by giving you the specially trained immune T-cells before cancer even appears.

Wouldn’t that be an amazing breakthrough?

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