Buffalo, New York: A first-in-human study suggests a potential shift in how CAR-T therapy — one of the most advanced cancer treatments — is delivered. Instead of engineering immune cells outside the body, researchers in China have found early success in reprogramming them directly inside patients, a move that could make the therapy faster, simpler and potentially much cheaper.
The study, published in March 2026 in Nature Medicine, suggests that while Chimeric antigen receptor T-cell (CAR-T) therapy has transformed treatment for certain blood cancers, its process remains cumbersome. Immune T cells are extracted from a patient, genetically modified in specialised labs, and reinfused after preparatory chemotherapy. This complex pipeline has kept costs high and access limited.
The new approach, tested through an experimental drug known as ESO-T01, seeks to bypass much of that infrastructure.
The trial drug works by instructing immune cells to recognise and attack myeloma cells without the need for external manipulation. This stands in contrast to currently approved CAR-T therapies such as Abecma and Carvykti, which rely on ex vivo cell engineering — a process that involves weeks of lab work, specialised facilities and logistical coordination.
In the phase 1 trial last year, researchers delivered a gene-editing agent intravenously, allowing immune cells to be modified within the patient’s body itself. The study focused on individuals with relapsed or treatment-resistant multiple myeloma, a cancer that originates in plasma cells in the bone marrow and is often difficult to treat in later stages.
Early findings
Early findings from a small cohort indicate that the process of engineering cells inside the body can be carried out with manageable safety risks. Most adverse effects reported were temporary and resolved within 48 hours. Crucially, no life-threatening toxicities were observed in this initial group.
Since the treatment is administered as a single infusion, scientists expect it to be much cheaper and simpler to produce than current CAR-T therapies, which require separate blood-drawing, lab-processing, and long-distance shipping. If larger trials confirm both safety and benefit, this therapy could become a “ready-to-use” treatment that is priced far lower than today’s expensive CAR-T products and could be introduced globally.
In India, CAR-T therapy typically costs around Rs 35-50 lakh per patient, and this new in-body approach could lead to price drop by up to about 90 per cent, according to Mei Heng, a professor at Union Hospital in Wuhan, where the first trial of this therapy was conducted.
Researchers at the Belgian biotech company EsoBiotec, in collaboration with Chinese hospitals, are also testing this new approach in cancer patients through early stage trials in 2024, with results reported in 2025-2026.
The potential has already drawn industry attention. AstraZeneca acquired EsoBiotec in the second quarter of 2025.
Still, researchers caution that the findings remain preliminary. The main study cohort that ended in 2025 included only five patients, and long-term safety and efficacy data are not yet available. A larger phase 1 study currently underway in China at Wuhan Union Hospital is expected to provide more comprehensive insights into how the therapy performs across a larger cohort.
Arun Singh is an intern at ThePrint. He is an alumnus of ThePrint School of Journalism.
(Edited by Stela Dey)