Март 2023: CAR-T-cell therapy is a novel and effective cancer treatment modality that has revolutionized the treatment of cancer, particularly blood cancers. This therapy achieves a therapeutic effect or cures disease by repairing or reconstructing genetic materials that have been damaged. Since Roseberg first isolated tumour-infiltrating lymphocytes (TILs) to treat melanoma in 1986, the development of modified T cell therapy has gained significant momentum. Since the FDA approved the first CAR-T терапия, Kymriah, in 2017, the CAR-T market has grown rapidly. According to Frost & Sullivan, the global CAR-T market size is projected to increase from USD 10 million in 2017 to USD 1.08 billion in 2020, and then to USD 9.05 billion in 2025, with a compound annual growth rate (CAGR) of 55% from 2019 to 2025, making it the fastest-growing segment of the global cell and gene therapies (CGT) market.
CAR-T therapy is one of CGT therapy’s subsegments. On the basis of the origin of T cells, CAR-T therapy can be divided into two categories. Autologous CAR-T-cell therapy, which employs the patient’s own immune cells, and allogeneic CAR-T-cell therapy, which employs T cells from donor blood or occasionally umbilical cord blood,. The majority of CAR-T therapies are autologous Т-клеточная терапия CAR, which typically involve the steps outlined below:
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1) Т-клетки берут из периферической крови пациента;
2) Viral vectors such as AAV then modify T cells with CAR genes that are directed against a specific cell-surface protein on cancer cells;
3) The modified CAR-T cells population is expanded according to the patient’s weight;
4) The expanded CAR-T cells are then reinfused back into the patient. The entire manufacturing procedure lasts between one and three weeks and requires GMP compliance in an ultra-clean environment.
CAR-T therapy has reached a level of success that has never been seen before in treating B-cell cancers that are resistant to or refractory to chemotherapy, including R/R, B-ALL, NHL, and MM. The effectiveness of treating solid tumours is also currently under investigation. CD19-targeting and BCMA-targeting CAR-T therapies achieve the greatest clinical success among all CAR-T therapies. Four of the six CAR-T therapies approved by the FDA target CD19, while two target BCMA.
The most significant advantage over small and large molecule drugs is that patients can replace lifelong treatment of chronic disease with a limited number of doses, or even just one.
The United States pioneered the development of the CAR-T industry. However, by the middle of the 2010s, China had learned quickly and was catching up to the United States. Principally, the key drivers can be attributed to the Chinese government’s support for the development of a CGT ecosystem comprised of biotech companies, academics, healthcare providers, investors, and the government. Following the prioritization of biotechnology in the thirteenth five-year plan, the Chinese government emphasized its strategy to accelerate the innovation and development of biotech industries, including cell therapy. In addition, pertinent ministries have issued encouraging action regulations.
После публикации в 2015 году Заключения Госсовета о реформе системы экспертизы, экспертизы и одобрения лекарственных средств и медицинских изделий активизировался и рынок капитала. При совокупном годовом темпе роста в 45% китайские компании, занимающиеся клеточной терапией, привлекли около 2.4 млрд долларов США в период с 2018 по 2021 год.
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The number of CAR-T therapy trials in China surpassed those in the United States by 2018 as a result of this thriving ecosystem. As of June 2022, Chinese companies had conducted 342 clinical CAR-T trials. Malignancies in the B lineage were among the most prevalent manifestations. Two CAR-Т products have commercial applications: Йескарта в июне 2021 года и Релма-чел in September 2021, among numerous drug candidates.
По данным Frost & Sullivan, внутренний рынок CAR-T, по прогнозам, увеличится с 0.2 млрд юаней в 2021 году до 8 млрд юаней в 2025 году, а затем до 28.9 млрд юаней в 2030 году при среднегодовом темпе роста 45% с 2022 по 2030 год. тот факт, что китайский рынок CAR-T все еще находится в зачаточном состоянии, является сильной движущей силой.
Although the two approved CAR-T products are from Sino-US joint ventures Fosun Kite and JW Terapeutics, domestic players have made breakthroughs and caught up to global players in recent years. Legend Biotech, IASO Biotherapeutics, and CARsgen Therapeutics all obtained NDA approval for their BCMA CAR-T products, establishing them as the leaders in BCMA CAR-T therapy. CD19 CAR-T products are a focus for Juventas Therapeutics, Gracell Biotechnologies, Hrain Biotechnology, ImunoPharm, Shanghai Cell Therapy Group, and numerous domestic companies. Juventas Therapeutics is the leader in Chinese CD19 CAR-T терапия now that the NMPA has accepted its NDA for CNCT19. CARsgen Therapeutics is a global leader in solid tumours, and CT041 is the first CAR-T candidate for treating solid tumours to enter Phase II клинические испытания. Bioheng Biotech и BRL Biotech (китайский: ) создают новые рынки аллогенных CAR-T.
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