The Week India - July 29, 2018

THE WEEK · JULY 29, 2018 39

HEALTH

expensive and the companies that
bear this initial expense want to
make profi ts from their innova-
tion. So under the current system
of drug development I cannot see
costs coming down except if in-
stitutions develop their own pro-
grammes for locally made CAR-T
cells. Our method is exceptionally
cost effective compared to the com-
mercial CAR-T therapy approved
in the US at a cost of $385,000 to
$485,000 per treatment.
With the CliniMACS Prodigy de-
vice, the entire process is performed
in a laboratory on the Froedtert &
MCW academic medical center
campus, saving precious time for
the patient.
Does this new trend in cancer treat-
ment, which trains the patient’s
own immune cells to kill the can-
cer, mean the age of chemotherapy
and radiation is almost over?
Not yet. We will still be using radi-
ation/ surgery and chemotherapy;
a signifi cant number of cancers are
cured with those right now. Immu-
notherapy and cellular immuno-
therapy such as CAR-T cells will
transform cancer treatment in a big
way going forward.

There has been several setbacks

during human trials. Would pro-

viding arms to our own immune

cells cause any unexpected side ef-

fects?

Yes, this is important. We can ex-

pect, and we see, immunotherapy

associated toxicity including au-

toimmunity against normal cells.

Also, CAR-T cells can cause a

variety of toxicities including

something called cytokine release

syndrome that needs expert man-

agement.

How different is the CAR-T treat-

ment different from the vaccines

developed at Stanford?

They are two very different tech-

niques. Think of sending guns to

freedom fi ghters (vaccine) versus

sending troops to fi ght their war

(CAR-T). Vaccines in general

use proteins or cell fragments to

stimulate a sustained immune

response. We use live cells to in-

duce tumour killing. CAR-T is

not a vaccine in that it involves

giving living cells; not trying to

stimulate preexisting immunity.

We do work on vaccines, too,

with clinical trials for diseases

such as myeloma. ◆

TRIUMPHANT TEAM:

(From left to right)

Parameswaran Hari,

Nirav Shah, Bret

C., Bryon Johnson,

professor of pediat-

rics in the division

of hematology and

oncology at MCW and

David Margolis, MD,

Children’s Hospital of

Wisconsin

DR PARAMESWARAN HARI