OnCo
ideasIdea

In vivo CAR-T manufactured and priced like a generic biologic

Instead of making cell therapy from each patient's own cells in a factory, inject a particle that reprograms immune cells inside the body, made in bulk, so a dose costs thousands rather than hundreds of thousands.

Autologous CAR-T costs hundreds of thousands of dollars and weeks of manufacturing per patient, restricting it to a small fraction of eligible patients in rich countries. In vivo CAR generation with lipid nanoparticles or targeted lentiviral vectors (Umoja, Interius, Orna and others) has entered the clinic in B-cell malignancies. The proposal is a coordinated programme to develop an in vivo CD19 or BCMA product with a manufacturing process and cost-of-goods target under $5,000 per dose, licensed for distribution through generic-style manufacturers in middle-income countries, with regulatory pathways agreed in advance.

Hypothesis
An off-the-shelf in vivo CAR product achieves complete remission rates within 15 percentage points of autologous CAR-T in relapsed B-cell malignancies at less than a tenth of the delivered cost, enabling treatment of ten times as many patients.
Rationale
The cost of autologous therapy is in logistics and bespoke manufacturing, not in the biology; nucleic acid-lipid manufacturing scales like a vaccine.
What would test it
Phase 2 in relapsed large B-cell lymphoma with pre-specified cost-of-goods reporting and a parallel technology transfer to a manufacturer in India or Brazil.
Maturity
preclinical evidence
Who has to act
industry
Cost to try
Large (over $50M)
Years to first evidence
7
Bottlenecks it attacks

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