CAR T-Cell therapy in Korea

May 2022 : The CAR T-cell Therapy Center at Samsung Medical Center is the only facility in all of Korea that offers this type of treatment. Eleven patients in Korea who were diagnosed with refractory diffuse large B-cell lymphoma have successfully undergone the procedure for the first time, and approximately 20 patients are currently in line to receive treatment before the end of the year.

CAR T-cell therapy, developed by Novartis and marketed under the brand name Kymriah, is currently being provided by the CAR T-cell Therapy Center to patients under the age of 25 who suffer from B-cell acute lymphoblastic leukaemia or diffuse large B-cell lymphoma. In addition, patients who have refractory diffuse large B-cell lymphoma are the focus of clinical trials being conducted for CRCO1, which was developed by a company based in Korea called Curocell. In addition, because Korea is widely recognised as the CAR T-cell Therapy hub in the world, clinical trials for the CAR T-cell therapy developed by Janssen are also currently being conducted for patients who have relapsed or refractory multiple myeloma.

Before beginning treatment, patients undergoing CAR T-cell therapy are required to coordinate their efforts with a number of different hospital departments. To be more specific, a large number of specialists in fields that are closely related to infectious disease, neurology, cardiology, and intensive care are involved in the comprehensive management that takes place after treatment.

The CAR T-cell therapy centre is currently participating in the “Research-oriented Hospital R&D Project” by the Ministry of Health and Welfare, and it is expected to become a cell therapy centre that leads high-level cell therapy and patient-specific treatment for haematological oncology patients. The project was initiated by the Ministry of Health and Welfare.

CAR-T is a technique that enables T cells, which are common immune cells in the blood, to target cancer cells after they have been detected. After removing T-cells from patients, amplifying T cells containing genes, and injecting them into patients’ bodies, CAR-T handles them by adding unique Vehicles.

On November 16, ViroMed, a Korean firm, announced a plan to develop a CAR-T drug. CAR gene optimization technology, vector production technology, and ex vivo technology for gene transfer and cell proliferation are all available to the business for the development of CAR-T drugs. After selling “VM801,” ViroMed’s own CAR-T technology, to US Bluebird Bio for 56.8 billion won in December 2015, the company plans to produce three CAR-T products.

In addition, AbClon is developing a blood cancer treatment based on technology developed by a research team led by professor Jung Jun-ho of Seoul National University in February, which is safer than current CAR-T drugs. The team’s technology is known to distinguish itself from current drugs by greatly reducing cytokine release syndrome (CRS), a detrimental side effect of CAR-T drugs that can cause hypotension, fever, and even death in patients.

To top it off, Green Cross Cell, a subsidiary of Green Cross, is screening and validating CAR-T drug candidates for solid cancer treatment. The company intends to conduct research in order to begin a pre-clinical trial next year. Since naming Son Ji-woong as head of the Life Science Business Division in February, LG Chem is said to have been contemplating the implementation of technology related to CAR-T drugs, with the production of diabetes drugs and immunological anti-cancer drugs being the company’s key R&D mission.

Curocell, a South Korean biotech startup that pioneered CAR-T cell therapy, is planning to launch a clinical trial of a novel CAR-T cell therapy that targets both blood cancer and solid tumours.

Curocell recently submitted an IND application for a clinical trial of its CAR-T cell therapy in Korea, and the company’s chief executive Kim Gun-soo told Maeil Business Newspaper that the Ministry of Food and Drug Protection is expected to approve it this month.

Curocell has already formed a strategic alliance with Samsung Medical Center to kick-start the trial as soon as it is approved, according to Kim, who hopes to get the groundbreaking cancer therapy to Korean patients as soon as possible.

CAR-T is an immunotherapy that is programmed to identify and destroy cancer cells. T cells from a single patient are genetically engineered in a lab to produce cancer-specific chimeric antigen receptors in order to create this treatment. After that, the cancer-fighting cells are re-infused into the patient’s body.

CAR-T cell therapy has been shown to be more successful than any other cancer treatment currently available. According to Kim, despite failing other therapies, 82 percent of acute leukaemia patients and 32-36 percent of lymphoma patients became cancer-free with a single CAR-T cell infusion.

However, CART’s high efficiency results are limited to the treatment of blood cancer cells and cannot be replicated for solid tumours due to the immune checkpoint receptor (PD-1) found in solid cancer patients’ immune cells, which inhibits immune cell activity.

The immune checkpoint receptor serves as a brake on immune cells’ ability to function. When immune checkpoint receptors like PD-1 are overexpressed, immune cells’ ability to remove cancer cells decreases, making tumour removal more difficult.

Curocell’s OVIS (Overcome Immune Suppression) technology overcomes this restriction, allowing CAR-T cell therapy to be used to treat solid tumours. OVIS is a genetic engineering technology that uses genetic modification of immune cells to suppress immune checkpoint receptor RNA (ribonucleic acid). A new CAR-T cell therapy implemented with this technology was more successful than a current CAR-T treatment in an animal model, according to Kim.

Except for Curocell’s therapy, none of the CAR-T cell therapies that are currently available or in clinical trials will target both blood cancer and solid tumours, according to Curocell.

New advanced drugs, such as CAR-T (chimeric antigen receptor T-cell), are life-changing medications for people who have exhausted their possible treatment options. These cutting-edge treatments are provided in non-traditional ways, including long, complicated, and highly organised series of activities inside the healthcare provider’s facilities. Providers will benefit from these treatments in a variety of ways, from enhancing their reputation as cutting-edge organisations to providing high-profit-generating programmes. However, delivering these latest advanced treatments poses significant financial and operating challenges if not carefully assessed and prepared.

What is CAR T-Cell therapy (Chimeric antigen receptors)?

CAR T-Cell therapy is a form of immunotherapy that uses specially modified T-cells which are part of our immune system to fight cancer. A sample of patients T cells are collected from the blood, then it is modified to produce special structures called chimeric antigen receptors (CAR) on their surface. When these modified CAR cells are re infused in the patient, these new cells attack the specific antigen and kills the tumor cells.

How does CAR T-Cell therapy work?

CAR T-cell therapy takes help from body’s own immune system to attack and kill cancer cells. This is done by removing some specified cells from the blood of the patient, modifying them in the lab and re-injecting them into the patient. CAR T-cell therapy has produced very encouraging results in Non-Hodgkin lymphoma and thus approved by FDA.

Who are the right candidates for CAR T-Cell therapy ?

At present FDA has approved CAR T-Cell therapy for some forms of aggressive and refractory Non-Hodgkin lymphoma, Myeloma and relapsed and refractory acute lymphoblastic leukemia. Patient need to send full medical reports to ascertain the use of CAR T-Cell therapy for his treatment.

Inclusion criteria for CAR T-cell therapy :

1. Patients with CD19+ B-cell Lymphoma(At least 2 prior combination chemotherapy regimens)

2. To be aged 3 to 75 years

3. ECOG score ≤2

4. Women of childbearing potential must have a urine pregnancy test taken and proven negative prior to the treatment. All patients agree to use reliable methods of contraception during the trial period and until follow-up for the last time.

Exclusion criteria for CAR T-cell therapy :

1. Intracranial hypertension or unconsciousness

2. Respiratory failure

3. Disseminated intravascular coagulation

4. Hematosepsis or Uncontrolled active infection

5. Uncontrolled diabetes

Advantages of CAR T-Cell therapy

>5000 CAR T cases done by highly skilled doctor’s.
Hospitals in China has developed more CAR T Cell types including CD19 & CD 22 then any other country in the world.
China is conducting more than 300 clinical trials on CAR T Cell therapy. More than any other country on the planet.
Clinical effect of CAR T Cell is similar to that in USA or any other country and sometimes better.

Treatment process for CAR T-Cell therapy

Complete evaluation of the patient
T-cell collection from the body
T-cells are then engineered in the lab
Genetically engineered T-Cells are then multiplied by using growing them in the laboratory. These cells are frozen and then sent to the treating centres.
Prior to infusing, patient may be given chemotherapy for their cancer. This helps the therapy work in a better way.
Soon after chemotherapy CAR T-Cells are infused by a process which is similar to blood infusion.
There is a 2-3 month of recovery period for the patient.

Time frame for CAR T-Cell therapy

1. Examination & test: one week

2. Pre-treatment & T-Cell Collection: one week

3. T-Cell preparation & return: two-three weeks

4. 1st Effectiveness analysis: three weeks

5. 2nd Effectiveness analysis: three weeks

How much does CAR T-Cell therapy cost ?

At present CAR T Cell therapy in Singapore has been tried at clinical trials level and there is still time for FDA approval to these sites. We all hope that it is under the affordability of most the patients who suffers from these deadly diseases.

Also read this : CAR T Cell therapy in India

Side effects of CAR T-Cell therapy

The common side effects of CAR T-cell therapy include:

Cytokine release syndrome
In some cases, patients may develop flu-like symptoms such as fever, chills, headache, nausea, vomiting, loose stools, and muscle or joint pains. It may also cause low blood pressure, difficulty in breathing, and a fast heart rate. These side effects are due to the release of cytokines by the immune cells during CAR T-cell therapy. These symptoms are usually mild, but can be serious and life threatening in some patients.
Neurological events
Neurological events can occur and can be serious in some patients. Such events include encephalopathy (brain injury and malfunction), confusion, difficulty speaking, agitation, seizures, drowsiness, altered state of consciousness and loss of balance.
Neutropaenia and Anaemia
Some patients may develop neutropenia or low white cell count. Similarly, anaemia or low red blood cell count may also occur due to this therapy.
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Fortunately, most of these side effects usually resolve on their own or can be managed with the use of medications.

How effective is CAR T-Cell therapy ?

CAR T-cell therapy for the treatment of lymphoma and other blood cancers has shown promising outcomes. Since CAR T-cell treatment, many patients who had previously relapsed blood tumours had promising results and no evidence of cancer. It has also aided in the rehabilitation of patients who have previously failed to respond to most traditional cancer therapies.

However, longer-term studies for a larger patient population are needed to validate the efficacy of this treatment. Large-scale experiments would also aid in determining the likelihood of side effects and the right ways to deal with them.

How can I take CAR T-Cell therapy in South-Korea ?

Patient can call +91 96 1588 1588 or email to info@cancerfax.com with patient details and medical reports and we shall arrange for second opinion, treatment plan and estimate of expenses.

Also read this: CAR T Cell therapy for solid cancers