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发展中国家的 CAR-T 细胞治疗:还要等待多久?

英文原题:CAR-T cell therapy in developing countries: how long should we wait?

查看英文原题

CAR-T cell therapy in developing countries: how long should we wait?

PubMed 2024/12/22(内容时间) J Immunother Cancer Q1 · IF 11.7(JCR 2025)

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中文摘要

低收入和中等收入国家(LMICs)面临着沉重的癌症患病率和发病率负担。然而,这些地区癌症患者的生存率明显低于高收入国家,主要原因是诊断较晚和难以获得先进治疗。嵌合抗原受体(CAR)T细胞疗法在某些晚期癌症患者中已展现出令人鼓舞的疗效,但在包括尼泊尔在内的LMICs中,获得该治疗的机会仍然有限。尼泊尔再生医学中心已启动相关努力,使癌症患者能够以大幅降低的费用获得CAR-T 细胞疗法。该举措包括成功开展研究,以使用本地采购或来自发达国家的试剂来检验本地实验室能力的可行性。此外,一个符合药品生产质量管理规范(GMP)级别的CAR-T 细胞生产设施正在建设中,以启动临床生产。这一努力遇到了若干挑战,包括技术困难、监管障碍和资源限制,这些可为其他发展中国家提供宝贵借鉴。尼泊尔的这一经验凸显了跨学科合作、知识共享、资金支持以及全球科学界创新解决方案的重要性,以实现先进医疗治疗的公平可及。

展开英文摘要原文

Low- and middle-income countries (LMICs) face a significant burden of cancer prevalence and incidence.

However, the survival rates for patients with cancer in these regions are notably lower than those in high-income countries, primarily due to late diagnosis and limited access to advanced treatments. Chimeric antigen receptor (CAR) T-cell therapy has demonstrated promising outcomes in certain terminally ill patients with cancer, yet access to this treatment remains limited in LMICs, including Nepal.

The Center for Regenerative Medicine in Nepal has initiated efforts to make CAR-T cell therapy accessible to patients with cancer at a substantially reduced cost. This initiative includes successful research to test the feasibility of local laboratory capabilities using reagents sourced locally or from developed countries.

Additionally, a Good Manufacturing Practicies (GMP) grade CAR-T cell manufacturing facility is being established to commence clinical manufacturing. This endeavor has encountered several challenges, including technical difficulties, regulatory barriers, and resource limitations, which could provide valuable insights for other developing countries.

This experience from Nepal highlights the importance of interdisciplinary collaboration, shared knowledge, funding, and innovative solutions from the global scientific community to achieve equitable access to advanced medical treatments.

论文信息

作者
Gautam S、Gautam B、Shilpakar R、K C S、Kurmi OP
第一作者单位
Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA Om.kurmi@coventry.ac.uk sanjivan@outlook.com.United States
通讯作者单位
Center for Regenerative Medicine, Kathmandu, Nepal Om.kurmi@coventry.ac.uk sanjivan@outlook.com.United Kingdom
期刊
Journal for immunotherapy of cancer2024 Dec 22
原文标识
PubMed 39794933 · DOI 10.1136/jitc-2024-009611