Brazil’s low-cost CAR-Ts take on Global South

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Brazil is the first country in Latin America to produce its own cut-price chimeric antigen receptor (CAR)-T cell therapies. Now, Caring Cross, a US-based non-profit focused on making advanced therapies affordable, plans to expands Brazil’s model to Turkey and the Middle East.

The price of autologous CAR-T therapies, which involve modifying a patient’s T cells to attack cancer cells, is typically over $500,000, putting them out of reach of most patients. Low- and middle-income countries have been working to reduce the costs by developing their own intellectual property, enhancing manufacturing efficiency and identifying biomarkers to predict responders.

Brazil, the most populous country in Latin America, has a public Unified Health System that provides free healthcare to over 200 million people. It ranks 12th in the global list of countries with the highest number of active gene therapies in clinical trials registered on ClinicalTrials.gov. Its CAR-T therapies — resulting from a collaboration between the Ministry of Health-funded technology transfer agreements between Caring Cross and the Brazilian public research institute Fiocruz — will start clinical trials later this year.

Cost-reducing changes in manufacturing involve the use of a soluble antibody to select for T cells rather than an expensive column-based selection step. In addition, high-titer vectors from Vector BioMed, a contract development and manufacturing organization spun out from Caring Cross, cost approximately half the price of its competitors.

Highly skilled labor is also more affordable in low- and middle-income countries, as are manufacturing facilities, all of which brings CAR-T cell products’ price tag down to $35,000 per dose. “Our strategy ensures that a significant portion of the supply chain materials for these advanced medicinal products is sourced locally, thereby guaranteeing both cost-effectiveness and long-term sustainability,” says Boro Dropulić, executive director and co-founder of Caring Cross.