Nepal begins CAR T-cell therapy for cancer patients

Nepal has used locally manufactured, genetically engineered cells to treat cancer for the first time. This marks a major expansion of the country’s cancer-treatment capabilities. The therapy was delivered at Tribhuvan University Teaching Hospital, or TUTH, in Maharajgunj.

The first recipient was a 20-year-old woman with relapsed acute lymphoblastic leukaemia. Her T-cells were collected and modified by the Kathmandu-based Centre for Regenerative Medicine Nepal. The product was designed to target CD19, a protein found on certain blood-cancer cells. The modified cells were then infused back into her body at TUTH.

About two weeks after treatment, her condition was stable. Doctors led by Dr Anjan Shrestha were monitoring whether the therapy had induced remission and how long any response might last. The treatment is currently available only at TUTH, although CRM Nepal plans to supply cells to other cancer centres.

CAR T-cell therapy is an emerging treatment that strengthens the body’s immune response against cancer. It uses the patient’s own T-cells, which are important immune-system cells. The approach matters because it gives those cells new instructions for identifying particular cancer cells.

Doctors first collect T-cells from the patient. Genetic engineering then modifies them in a laboratory so they can recognise a cancer-related target. The altered cells are multiplied before being infused back into the patient. Once returned, they are intended to recognise and destroy cancer cells carrying that target.

CRM Nepal’s product targets CD19, a protein found on certain blood-cancer cells. The first Nepali patient received these modified cells at TUTH. Doctors are monitoring whether the treatment produces remission and how long the response lasts. It is generally used for aggressive blood cancers after standard treatments fail or cancer returns.

Nepal’s CAR T-cell service is still highly limited. The treatment is currently available only at Tribhuvan University Teaching Hospital in Maharajgunj. CRM Nepal operates a centralised manufacturing facility in Kathmandu and plans to supply its locally produced cells to other cancer centres.

The article gives a comparison from India, where Dr Shivaji Poudel said CAR T-cell therapy costs more than Rs 7 million per patient. Nepali patients needing specialised care have also travelled to countries including India and China. The article does not state a Nepal price for the new treatment.

Local availability could make treatment easier to reach for patients who can afford it. It could also reduce the financial burden created by overseas travel and treatment. Doctors expect other hospitals to begin offering CAR T-cell therapy soon, but the service remains concentrated at TUTH for now.

CAR T-cell therapy is used for certain aggressive blood cancers. The article specifically names B-cell acute lymphoblastic leukaemia, or B-ALL, and diffuse large B-cell lymphoma, or DLBCL. It is generally considered when cancer returns after treatment or does not respond to earlier therapy.

This means the treatment is not usually a first choice. Doctors involved in Nepal’s programme said patients must first undergo standard treatments, including chemotherapy. If those treatments fail or the cancer returns, doctors may then consider CAR T-cell therapy. Such disease is described as relapsed or refractory.

The reason for this sequence is that CAR T-cell therapy is intended for difficult cases after established treatments have not worked adequately. Nepal’s first patient had relapsed acute lymphoblastic leukaemia, fitting that use. Doctors are now assessing whether the therapy induces remission and how long the response lasts.

Producing CAR T-cells in Nepal could reduce the practical and financial strain on people needing this specialised treatment. Until now, patients have travelled to countries including India and China for care. Such treatment can cost tens of millions of rupees, adding major expense to an already difficult illness.

CRM Nepal now manufactures the patient-specific cells in Kathmandu, while doctors infuse them at TUTH. Dr Poudel said CAR T-cell therapy costs more than Rs 7 million per patient in India. Having the production platform and treatment site inside Nepal could reduce the need for international travel and make care more accessible to patients who can afford it.

The benefit is not yet nationwide. The therapy is currently offered only at TUTH, and the article does not give a Nepal price. CRM Nepal plans to supply other cancer centres, while doctors expect more hospitals to start the service soon.

Nepal’s programme began with preclinical research in 2022. That research continued through 2024. In 2025, the teams prepared for manufacturing, trained workers, and developed a production facility. These steps created the foundation for making patient-specific CAR T-cells locally.

CRM Nepal then established a centralised production platform in Kathmandu. Its teams carried out the genetic engineering and other work needed to manufacture and assess the cells. In March 2026, the Department of Drug Administration approved CRM Nepal’s locally developed CD19 CAR T-cell product for clinical use.

A clinical team led by Dr Anjan Shrestha, alongside Dr Prashun Upadhyaya, administered the therapy at TUTH. The first patient received it about two weeks before the report. Doctors are monitoring her health, response, possible remission, and the duration of any benefit. More patients will also receive the therapy.

T-cells are a key component of the immune system. In CAR T-cell therapy, doctors collect these cells from the patient and give them a new ability to identify cancer. This matters because the modified cells can be directed toward a specific marker on cancer cells.

Genetic engineering changes the T-cells in a laboratory so they recognise CD19. CD19 is a protein found on certain blood-cancer cells. After modification, the T-cells are multiplied and infused back into the patient. Their intended action is to find cells carrying CD19 and destroy them.

CRM Nepal’s locally developed product targets CD19. It was used for Nepal’s first CAR T-cell patient, who had relapsed acute lymphoblastic leukaemia. Doctors are monitoring the treatment’s effect because the therapy must show whether it induces remission and how long the response lasts.