Consultant, Haemato-Oncology & BMT, Fortis Hospital, Shalimar Bagh, New Delhi
Part 6 of 8 in CAR-T Cell Therapy
CAR-T Cell Therapy Outcomes: What the Data Shows
September 6, 2026
For patients who have already relapsed after chemotherapy and a transplant, CAR-T does not promise a cure in every case. Dr. Akash Khandelwal was candid about what the response rates actually look like, and shared one patient's journey from the Netherlands to Fortis Shalimar Bagh.
A patient who had run out of options at home
One of Dr. Khandelwal's patients came to Fortis Shalimar Bagh from the Netherlands after his splenic marginal zone lymphoma progressed and he was deemed unfit for an autologous transplant in his own country, where no CAR-T option existed for his case. He found Dr. Khandelwal's team on his own, travelled to India for CAR-T, and was successfully discharged. He is now leading a full life he says he had lost hope of having.
Forty percent for lymphoma, seventy percent for leukaemia
Long-term relapse-free survival after CAR-T is around 40 percent for lymphoma and around 70 percent for leukaemia. Dr. Khandelwal frames these numbers honestly: this is not a 100 percent cure rate, but it is still a good result in a patient population that had already failed chemotherapy and relapsed after transplant, a genuinely difficult disease subset with few other options left.
The open question: making the response last
The biggest challenge with CAR-T today is that the engineered cells do not always persist in the body long-term, or the cancer develops resistance to them over time. More research is underway into how to help CAR-T cells expand and persist for longer after infusion, which should improve how durable these responses are. Even with that open question, Dr. Khandelwal describes CAR-T as a great improvement over standard of care for patients who had lost hope and were heading toward palliative care, giving them a real, longer-term chance of survival.
This article is based on a Jivo Masterclass session conducted by Dr. Akash Khandelwal, Consultant, Haemato-Oncology & BMT, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Akash Khandelwal taught doctors across Africa on March 9, 2025.
FROM THE LIVE Q&A
Dr. Rabiu Salisu Abdullahi (Nigeria)
Is there any risk to hair regrowth after the chemotherapy and CAR-T treatment?
Dr. Akash Khandelwal
The conditioning chemotherapy is just cyclophosphamide and fludarabine, which can cause cytopenias and neutropenia, but this is manageable since the dosing isn't very high, so fitness is not usually a major factor. It's the CAR-T related side effects that vary more from patient to patient. If the disease is well controlled going in, complications are less likely, but even with good control, side effects such as cytokine release syndrome or, less commonly, ICANS (which can affect the brain) can occur. Whatever side effects arise are manageable and not life-threatening: no deaths from CAR-T related side effects have been seen, and it isn't well documented even in the long-term data.
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Frequently Asked Questions
What are the specific cancer cells targeted by CAR-T, and can it be applied to ovarian or cervical cancers?▼
Not yet - it hasn't shown good promise there so far. Currently CAR-T is only available for B-cells, targeting CD19, and this has shown long-term responses based on research done in the US, with a large subset of patients still in remission after CD19-targeted CAR-T infusion. Other categories are in development too, such as dual-target CARs and attachments that help CAR-T expand and persist for longer, but currently only CD19 CAR-T can be offered, since that's what's commercially available in India.
Where do you see CAR-T cell therapy heading in other cancers?▼
CAR-T cells are likely to become a first-line option in almost all cancers within the next 5 to 10 years. If it doesn't get there, that would actually be a missed opportunity, because it targets cells in a very different and unique way. More and more data is showing increasing promise for the treatment.
If possible, could you share your slides with us so we can go through the presentation again?▼
Yes, no problem: the slides will be shared after the session.
How many CAR-T cells are required per kilogram of body weight?▼
The cutoff is 5 million CAR-T cells required per kilogram of the patient's body weight.
For the approved indications of relapsed or refractory diffuse large B-cell lymphoma and B-cell ALL, patients need to be over 15 years old. What is the name of the CAR-T product available in India, so I can look up the clinical trial research myself?▼
There are two CAR-T products commercially available in India right now, both targeting CD19. One is NexCAR19, made by ImmunoACT, which has been commercially available in India since December 2023, so there is more than a year of experience with it. The second product was launched only about a month back and is still underutilised. Both target CD19, the marker responsible for the B-cell response, so B-cell ALL and B-cell lymphoma are the appropriate targets, not Burkitt lymphoma (the CAR-T construct needed is different) or CNS lymphoma (which does not respond as well).
What are the response rates for CAR-T cell therapy?▼
Long-term relapse-free survival is around 40 percent for lymphoma and around 70 percent for leukaemia, in patients who had already relapsed after chemotherapy and a transplant.
Why doesn't CAR-T cure every patient?▼
The CAR-T cells do not always persist in the body long-term, and the cancer can develop resistance over time. Research is ongoing into extending how long CAR-T cells remain effective.
Has CAR-T helped patients with no other treatment options?▼
Yes. One patient travelled from the Netherlands after being deemed unfit for a transplant at home, received CAR-T at Fortis Shalimar Bagh, and was successfully discharged and is now living well.
In This Series: CAR-T Cell Therapy
- 1.CAR-T Cell Therapy
- 2.What Is CAR-T Cell Therapy and How Does It Work?
- 3.The CAR-T Cell Therapy Timeline: From Collection to Infusion
- 4.Who Is Eligible for CAR-T Cell Therapy?
- 5.Managing Complications After CAR-T Cell Infusion
- 6.CAR-T Cell Therapy Outcomes: What the Data Shows
- 7.The Cost and Availability of CAR-T Cell Therapy in India
- 8.The Future of CAR-T Cell Therapy: Beyond Lymphoma and Leukaemia