With advances in targeted cell therapy and immunotherapy, thousands of cancer patients in Karnataka are signing up for new, personalised treatments.
Efficacy is high, but not all patients are eligible for these therapies, say doctors.
Dr Satheesh C T, director of clinical trials at HCG Group, estimates that 4,000 patients opt for these new therapies every year in Bengaluru hospitals. Of them, about 250 are part of clinical trials. The numbers are growing steadily.
A handful of hospitals, including HCG, Manipal, Cytecare, are offering these treatments now. According to the Population Based Cancer Registry, Karnataka had 87,304 cancer patients in 2021.
Conventional chemotherapy harms healthy cells as well as cancer cells. But in targeted cell therapy, a specific biomarker in the cancer cell is identified, so that the drug targets only the cells with that biomarker.
Immunotherapy is an even more recent entrant to cancer care. Here, the focus is not on killing cancer cells directly, but on activating the patient’s own immune system to fight them. “In the last 10 years, there has been a shift in thinking, and immune cells are getting as much attention as cancer cells,” says HCG oncologist Dr Vishal Rao, a member of Karnataka State Vision Group for Biotechnology.
Here too, biomarkers have to be identified, and the treatment is personalised. “It isn’t easy, because you need to know how each person’s immune system will react,” says Suresh Ramu, CEO and co-founder of Cytecare Hospitals.
Elders eligible
Dr Nidhi Tandon of Narayana Health says an advantage of immunotherapy is that it can be given even to patients who are elderly and suffer comorbidities. Many elderly patients are considered ineligible for conventional therapies.
Targeted cell therapy and immunotherapy are often administered alongside surgery, radiation and chemotherapy, but sometimes in isolation. Treatment depends on the type of cancer and stage of advancement.
But since these therapies can't be initiated in people without specific biomarkers, a large section is left out. Of those who get tested for these therapies, on average only 35 per cent become eligible for treatment, says Dr Satheesh.
However, among those who do take the treatment, 70-80 per cent show fast results and report tumour control, symptom relief and longevity, he says. The new therapies are estimated to be 1.5 to 2 times more effective than chemotherapy.
Affordability
A major deterrent is the cost. One session of immunotherapy could cost as much as Rs 2 lakh. Typically, a patient takes the drug for about two years, which means the cost of medication alone comes to Rs 60-80 lakh, says Dr Satheesh.
Targeted cell therapy can cost Rs 50,000-70,000 per session, but the cost can go down to Rs 10,000-15,000 if generic drugs are available, says Dr Tandon. Since targeted cell therapy is relatively more affordable, more people sign up for it compared to immunotherapy.