Access to CAR-T therapy in Latin America: Barriers, gaps, and pathways forward

Area of Science:

• Oncology
• Immunotherapy
• Health Equity

Background:

• Chimeric antigen receptor (CAR) T-cell therapy has revolutionized hematological malignancy treatment.
• Access to CAR T-cell therapy remains a significant challenge in low- and middle-income countries, particularly in Latin America.

Purpose of the Study:

• To review the challenges hindering CAR T-cell therapy adoption in Latin America.
• To explore strategies for expanding access to this life-saving treatment in the region.

Main Methods:

• Review of existing literature on CAR T-cell therapy challenges and innovations.
• Analysis of cost, manufacturing, infrastructure, and regulatory barriers.
• Exploration of novel approaches like point-of-care manufacturing, allogeneic CAR-T, and mRNA-based therapies.

Main Results:

• High costs, complex manufacturing, inadequate infrastructure, and limited clinical trial representation are key barriers.
• Decentralized manufacturing models show potential for over 90% cost reduction.
• Allogeneic and mRNA-based CAR-T approaches offer reduced production times and improved tolerability.

Conclusions:

• Equitable CAR T-cell access in Latin America necessitates harmonized regulations, scalable manufacturing, infrastructure investment, and population-specific research.
• A combination of scientific innovation, policy reform, and regional collaboration is crucial for sustainable treatment expansion.