The National University Cancer Institute, Singapore (NCIS) has developed an innovative therapy that uses the immune system to fight cancer. Unlike traditional chemotherapy, CAR T Cell Therapy is customized, using the modification of a patient’s own blood cells to specifically target and eliminate cancer cells.
The use of gamma-delta T cells from healthy donors improves the quality of CAR-T cells while potentially cutting treatment costs, making this therapy even more attractive.
CAR T-Cell Therapy In Singapore – Current Status
CAR-T cell therapy has become a game-changer in the way cancer is treated, and Singapore is very excited about this new therapy. Singapore has made a lot of progress in adopting CAR-T cell therapy through clinical trials, partnerships, and regulatory support. This has helped patients and contributed to improvements in cancer care. Singapore is still at the top of CAR-T cell therapy because it keeps doing research and has a good healthcare system. CAR T-Cell therapy in Singapore has gained pace, giving cancer patients and their families hope.
With a number of clinical trials happening at National University Hospital, Singapore, Chimeric Agent Receptor (CAR) T-cell therapy is developing at a very fast pace in Singapore. Oscar Saxelby-Lee suffers from acute lymphoblastic leukemia, a disease that has resisted all treatments. The five-year-old from the United Kingdom is in Singapore for a procedure that has never been given to one other infant on the planet. The boy flew in from Worcester, England, for a new type of therapy that involves drawing immune cells from a patient’s blood and implanting them with a Chimeric Antigen Receptor (CAR-T).
Singapore Health Sciences Authority (HSA) has approved Kymriah (tisagenlecleucel) as the first commercial chimeric antigen receptor T-cell (CAR-T) therapy in Singapore under the new cell, tissue, and gene therapy products (CTGTP) regulatory framework. HSA approved Kymriah for the treatment of pediatric and young adult patients from 2 to 25 years of age with B-cell acute lymphoblastic leukemia (ALL) that is refractory, in relapse post-transplant or in second or later relapse; and for the treatment of adult patients with relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) after two or more lines of systemic therapy.
The receptor binds to a certain protein in cancer cells, causing CAR-T cells to activate and destroy the cancer cells. Since the leukaemia cells mimic Oscar’s immune system, this form of CAR-T therapy is unique and more complex, according to Associate Professor Allen Yeoh, head of pediatric oncology at the National University Hospital (NUH). Oscar will be the world’s second human to undergo this procedure. The first child was treated at NUH just a few years back.
CAR-T cell therapy is a new type of medicine that has changed the way people all over the world treat cancer. Singapore, which is known for its high-tech healthcare system and research infrastructure, was one of the first places to accept and use CAR-T cell therapy. In this piece, we’ll talk about where CAR-T cell therapy is right now in Singapore and how it affects cancer patients.
Singapore has medical facilities and study centers that are among the best in the world. These places have been very important to the progress of CAR-T cell therapy. Institutions like the National Cancer Centre Singapore (NCCS), the National University Cancer Institute Singapore (NCIS), and the Singapore General Hospital (SGH) have been heavily involved in clinical trials, research studies, and giving CAR-T cell therapy to patients.
Through different clinical studies, CAR-T cell therapy has made a lot of progress in Singapore. Different kinds of cancer, like leukaemia, lymphoma, and solid tumors, have been the focus of these studies. The results have been encouraging, showing a high rate of response and longer times of remission. The good results have made it possible for regulators to approve CAR-T cell treatment, which means it can now be used in clinical practice.
CAR-T cell treatment will be widely used only if it is easy to get and doesn’t cost too much. Singapore has taken steps to make sure that people can get this new treatment. Together with healthcare institutions, the Ministry of Health has worked on creating guidelines and reimbursement systems to make it easier for patients to get CAR-T cell therapy.
Singapore’s healthcare ecosystem puts a lot of emphasis on collaboration between healthcare workers, academics, and businesses. Singapore has been able to take part in international CAR-T cell therapy studies thanks to partnerships with the world’s top biopharmaceutical companies. These kinds of agreements have sped up research, made treatments more effective, and given more people access to cutting-edge therapies.
CAR-T cell treatment in Singapore looks like it will have a bright future. Ongoing study is focused on making CAR-T cell therapy more effective and safe, reducing the side effects of treatment, and finding ways to use it for a wider range of cancers. Singapore is a center for CAR-T cell therapy innovation because it is committed to research and development and has a good legal environment.
What Are CAR-T Cells And How Does It Destroy Cancer Cells?
CAR T cells, also known as Chimeric Antigen Receptor T cells, are immune cells that play an important part in CAR T Cell Therapy. These specialized T cells are engineered in a laboratory to express a chimeric antigen receptor on their surface. CAR T cells, also known as Chimeric Antigen Receptor T cells, are immune cells that play an important part in CAR T Cell Therapy. In a laboratory, these specialized T cells are designed to express a chimeric antigen receptor on their surface. This receptor is programmed to recognize specific proteins on the surface of cancer cells known as antigens. When the CAR T cells are identified by the immune system, they bind to the cancer cells, triggering a robust immune response. CAR T cells that have been activated grow and launch a targeted attack on cancer cells, effectively destroying them.
Which Conditions Can Be Treated By CAR T Cell Therapy In Singapore?
CAR T Cell Therapy is a kind of advanced immunotherapy that has shown significant effectiveness in treating specific conditions, particularly targeting patients facing challenging scenarios. This advanced therapy is particularly well-suited for individuals diagnosed with relapsed aggressive forms of Acute Lymphoblastic Leukemia (ALL), multiple myeloma, and cases of relapse in Non-Hodgkin Lymphoma, such as Diffuse Large B-cell Lymphoma (DLBCL). This is especially important when traditional treatments have failed and at least two past treatment approaches have proven ineffective in reaching the desired results. Thus, CAR T-Cell Therapy emerges as a promising therapy option for patients suffering from leukemia and lymphoma, providing them a beacon of hope and the promise for improved treatment outcomes in Singapore.
Easier Process Of Getting CAR T Cell Therapy
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Why choose Singapore for CAR T-Cell therapy?
Advanced Medical Infrastructure
Singapore is known for its cutting-edge technology and world-class medical facilities. The government has put a lot of money into healthcare and has a system that is strong and up to international standards. In 2010, the WHO put Singapore’s healthcare system sixth out of the 100 best in the world. At the moment, 22 hospitals and other medical facilities in Singapore have been approved by Joint Commission International (JCI).
Highly Skilled Medical Professionals
Singapore has a lot of highly skilled and experienced doctors, including oncologists and hematologists who specialize in CAR-T cell treatment. These specialists have been trained in the U.S. and abroad, and many of them have worked or studied in well-known medical institutions abroad.
Strict Regulations And Quality Control
The healthcare business in Singapore is controlled by strict rules and quality checks. Health officials in the country, like the Health Sciences Authority (HSA), make sure that medical treatments, like CAR-T cell therapy, meet strict standards for safety and effectiveness. This gives foreign patients who want to get treatment in Singapore peace of mind.
Multicultural And English-Speaking Environment
Singapore is a city with a lot of different cultures and people, and English is one of its recognized languages. This makes it a good place for foreign patients to go because communication is easy and quick. Patients from other countries can easily talk to their doctors, learn their treatment options, and have their medical concerns taken care of.
The Treatment Process Of CAR-T Cell Therapy
The CAR-T Cell Therapy Treatment Process consists of the following major stages:
Initial Consultation:
The patient suffering from cancer must consult with an oncologist to discuss his or her eligibility for CAR-T Cell Therapy.
The doctor will perform a thorough medical history and diagnostic evaluations of the patient.
After the evaluation, the patient will be informed about the treatment’s risks, advantages, and expectations.
Cell Collection and Modification:
T cells are collected from the patient via a technique similar to blood donation called apheresis.
These T cells are genetically engineered in the lab to express the chimeric antigen receptor (CAR).
Modified cells are cultured and multiplied to generate a sufficient quantity of CAR T cells.
Infusion Method:
To generate an environment suitable to CAR T cell activity, the patient goes through a conditioning process, which commonly involves low-dose chemotherapy.
Modified CAR T cells are then infused back into the patient’s bloodstream.
CAR T cells circulate in the body, identifying and attaching to cancer cells expressing specific antigens.
Monitoring and Follow-up:
After the entire infusion process, the patient will be closely monitored for potential side effects and the therapeutic response.
Follow-up appointments are scheduled regularly to check the efficiency of the treatment and handle any developing concerns.
Long-term monitoring ensures beneficial outcomes and addresses any potential issues in cancer patients.
What Is The Cost Of CAR T Cell Therapy In Singapore?
Kymriah CAR T-cell therapy, which the Singapore Medical Council has approved for the treatment of diffuse large B-cell lymphoma and B-cell acute lymphoblastic leukemia, can cost up to $ 475,000 USD i.e around $ 700,000 SGD.
CAR T-Cell Therapy Specialists In Singapore
Take an expert second opinion on CAR T-Cell therapy infusion from the best specialists in Singapore.
Dr. Ang Peng Tiam (MD, MRCP, FAMS, FACP)
MEDICAL ONCOLOGY
Profile: Medical Director and senior consultant at Parkway cancer center in the oncology division. Dr Ang is a council member of Singapore Cancer Society. He was also the past President of Singapore Society of Oncology..
Profile: Dr Colin received his medical degree from the National University of Ireland in 2002 and subsequently completed Internal Medicine residency and specialist training in Haematology at Singapore General Hospital.
Profile: Dr Colin received his medical degree from the National University of Ireland in 2002 and subsequently completed Internal Medicine residency and specialist training in Haematology at Singapore General Hospital.
The innovative immunotherapy method known as CAR T-cell therapy has shown exceptional promise in the treatment of a variety of malignancies. Beijing, China’s Peking University Cancer Hospital has become a global leader in the development of CAR T-cell treatment. With the help of their multidisciplinary team, which consists of oncologists, immunologists, and geneticists, personalized cancer treatment has advanced significantly. Peking University Cancer Hospital has obtained outstanding outcomes in patients with haematological malignancies by altering patients’ own T cells to express chimeric antigen receptors (CARs). This treatment gives cancer patients fresh hope and raising survival rates.
The National University Cancer Institute (NCIS) in Singapore is a well-known place that works to avoid, diagnose, and treat cancer. As a part of the National University Health System, NCIS gives people with cancer full and coordinated care. The institute brings together clinical expertise, cutting-edge research, and education to come up with personalized treatment plans that are based on scientific proof. The NCIS has state-of-the-art tools, such as advanced imaging technology and equipment for radiation therapy. They also offer an affordable cost of proton therapy in Singapore.
The main benefit is that CAR T-cell therapy only requires a single infusion and often only requires two weeks of inpatient care. Patients with non-Hodgkin lymphoma and pediatric leukemia who have just been diagnosed, on the other hand, typically need chemotherapy for at least six months or more.
The advantages of CAR T-cell therapy, which is a living medication, can persist for many years. If and when a relapse occurs, the cells will still be able to identify and target cancer cells because they can survive in the body for an extended period.
Although the information is still developing, 42% of adult lymphoma patients who underwent CD19 CAR T-cell treatment were still in remission after 15 months. And after six months, two-thirds of patients with pediatric acute lymphoblastic leukemia were still in remission. Unfortunately, these patients had exceedingly aggressive tumors that weren’t successfully treated using traditional standards of care.
What Type Of Patients Would Be Good Recipients Of CAR-T Cell Therapy?
Patients between the ages of 3 Years to 70 Years have tried CAR T-Cell therapy for different types of blood cancers and is very effective. Many centers have claimed success rates of more than 80%. The optimum candidate for CAR T-cell therapy at this time is a juvenile with acute lymphoblastic leukemia or an adult with severe B-cell lymphoma who has already had two lines of ineffective therapy.
Before the end of 2017, there was no accepted standard of care for patients who had already gone through two lines of therapy without experiencing remission. The only FDA-approved treatment that has so far proven to be significantly beneficial for these patients is CAR T-cell therapy.
How Effective Is CAR-T Cell Therapy?
CAR T-cell therapy has been very effective in treating some types of blood cancer, like acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma. In clinical trials, the response rates have been very good, and a lot of patients have gone into full remission. In some cases, people who had tried every other medicine had long-lasting remissions or even possible cures.
One of the best things about CAR T-cell treatment is that it targets the right cells. The CAR receptors that have been added to the T cells can find specific marks on cancer cells. This makes it possible to give targeted treatment. This targeted method hurts healthy cells as little as possible and lowers the risk of side effects that come with traditional treatments like chemotherapy.
But it’s important to keep in mind that CAR T-cell therapy is still a new area that is still changing. Researchers and doctors are working hard to solve problems like the high cost, the possibility of serious side effects, and the fact that it only works for some types of cancer.
In the end, CAR T-cell therapy has shown to be a very successful way to treat some types of blood cancer. Even though it is a promising and powerful method, more studies and clinical trials are needed to improve it and find new ways to use it. CAR T-cell therapy could change how cancer is treated and make things better for people all over the world if it keeps getting better.
Who Is Eligible For CAR T Cell Therapy In Singapore?
In Singapore, eligibility for CAR T Cell Therapy is selective and tailored for maximum effectiveness.
Eligible patients are children and young adults (3-25 years old) with resistant B-cell Acute Lymphoblastic Leukaemia (ALL) who have relapsed post-transplant.
CAR T Cell Therapy is also available to adults with Diffuse Large B-cell Lymphoma (DLBCL) who have not responded to at least two standard treatments.
However, certain patient groups may not meet the eligibility criteria, including those with intracranial hypertension or unconsciousness, respiratory failure, disseminated intravascular coagulation, hematosepsis, or uncontrolled active infection and diabetes. The careful selection of eligible patients ensures that CAR T Cell Therapy is provided to individuals who will benefit the most, increasing the likelihood of excellent treatment outcomes.
CAR T-Cell Therapies Approved By USFDA
KYMRIAH
B-cell precursor acute lymphoblastic leukemia, relapsed or refractory diffuse large B-cell lymphoma
Complete response rate (CR): >90%
Target: CD19
Price: $475,000
Approval time: August 30, 2017
YESCARTA
Relapsed or refractory diffuse large B-cell lymphoma, relapsed or refractory follicular cell lymphoma
Below are some of the side effects of CAR T-Cell therapy.
Cytokine release syndrome (CRS): The most prevalent and possibly significant side effect of CAR T-cell treatment is cytokine release syndrome (CRS). The flu-like symptoms, including fever, exhaustion, headaches, and muscle pain, are brought on by the modified T cells’ production of cytokines. In extreme circumstances, CRS may result in a high temperature, hypotension, organ failure, and even potentially fatal consequences.
Neurological Toxicity: Some patients may develop neurological side effects, which can range in severity from less serious signs like mild confusion and disorientation to more serious ones like seizures, delirium, and encephalopathy. After CAR T-cell infusion, neurological toxicity frequently happens during the first week.
Cytopenias: CAR T-cell treatment can result in low blood cell counts, such as anemia (low red blood cell count), neutropenia (low white blood cell count), and thrombocytopenia (low platelet count). Infections, bleeding, and exhaustion are among the risks that can be exacerbated by these cytopenias.
Infections: The CAR T-cell therapy’s suppression of healthy immune cells increases the risk of bacterial, viral, and fungal infections. In order to prevent infections, patients may need to be closely watched and given preventive medication.
Tumour Lysis Syndrome (TLS): After CAR T-cell therapy, it’s possible in some circumstances for substantial amounts of cell contents to be released into the bloodstream due to the rapid killing of tumor cells. This may result in metabolic abnormalities, such as excessive potassium, uric acid, and phosphate levels, which may damage the kidneys and cause other problems.
Hypogammaglobulinemia: CAR T-cell treatment has the potential to decrease antibody synthesis, which could result in hypogammaglobulinemia. This might make recurrent infections more likely and call for continuing antibody replacement medication.
Organ Toxicity: CAR T-cell therapy has the potential to harm a number of organs, including the heart, lungs, liver, and kidneys. This may lead to abnormal renal function tests, respiratory issues, heart issues, and abnormal liver function tests.
Hemophagocytic lymphohistiocytosis (HLH): A rare but possibly fatal immunological disease called hemophagocytic lymphohistiocytosis (HLH) can develop as a result of CAR T-cell therapy. It involves the overactivation of immune cells, which causes serious organ damage and inflammation.
Hypotension and Fluid Retention: As a result of the cytokines that CAR T cells release, some patients may develop low blood pressure (hypotension) and fluid retention. To address these symptoms, supportive measures including intravenous fluids and drugs could be required.
Secondary Malignancies: Reports of secondary malignancies emerging following CAR T-cell therapy exist, notwithstanding their rarity. Research is currently being done on the potential for secondary malignancies and long-term hazards.
It’s important to remember that not every patient will have these side effects and that each person’s level of sensitivity will differ. In order to minimize and minimize these potential adverse effects, the medical team closely examines patients before, during, and after CAR T-cell therapy.
Time frame
Check below the total time frame required to complete the CAR T-Cell therapy process. However, the time frame depends a lot on the distance of the lab from the hospital that prepared the CARs.
Examination & test: one week
Pre-treatment & T-Cell Collection: one week
T-Cell preparation & return: two to three weeks
1st Effectiveness analysis: three weeks
2nd Effectiveness analysis: three weeks.
Total time frame: 10-12 Weeks
How We Can Help You Get The Best CAR T Cell Therapy In Singapore?
Finding the right CAR-T Therapy in Singapore might be difficult, but we at Cancer Fax are here to help you every step of the way. We understand how important your health is, and sacrificing the quality of care is not an option. We have built connections with highly skilled doctors and partnered with several reputed hospitals to offer you a choice of pricing points that fit your needs, much like a trustworthy friend. Our goal is to help you access the best CAR T Cell Therapy without putting a strain on your finances. Our holistic approach to cancer care has already supported patients from diverse countries. Trust us to guide you and make sure you get the best treatment possible to fight against cancer and get well soon.
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CAR T Cell therapy in Singapore costs between 450,000 and 500,000 USD, depending on the type and stage of the disease and the hospital chosen.
Please send us your medical reports, and we will get back to you with details of the treatment, hospital, and cost estimate.
