CAR-T PROGRESS IN CHINA
That the initial approvals happened in the US was emblematic of how CAR-T development was centred primarily in the West, and more specifically the US, in the mid-2010s. Between 2010 and 2014, over half of newly identified CAR-T therapies were being developed or co-developed by a US-based company. In 2021, however, that figure fell to less than one third of new drugs. The reason for this was not a drop-off in American focus on CAR-T therapies, but instead a sharp increase in new CAR-Ts being developed by Chinese companies. The development of CAR-T therapies in China appears to markedly outpace research happening in the West, as per an analysis by Pharmaceutical Technology. CAR-T drugs now account for over 10% of new drugs developed by Chinese companies, compared to only 2% of drugs developed by US companies. Moreover, for each CAR-T therapy developed by US companies, there are 1.5 CAR-T therapies being investigated by Chinese companies. To understand how the CAR-T development
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sector has evolved since 2010, we paired drug and clinical trial data with information on the time CAR-T therapies were first identified by GlobalData as being in development. As the parent company of Pharmaceutical Technology, GlobalData tracks press releases, clinical registry protocols and research papers to identify new drugs. Even as the COVID-19 pandemic has slowed pharmaceutical research across the world, data shows that Chinese companies are still developing more CAR-T therapies than American entities.
Slow but steady There are several unique factors driving this surge in CAR-T developments in China: the need and demand for such therapies, government support, capital flow, and Chinese scientist-driven local research, says CAR-T investigator Dr Peihua (Peggy) Lu.
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CAR-Ts are a complex type of cell therapy,
where immune T cells are engineered to express chimeric antigen receptor (CAR) that binds to certain proteins on the tumour cells. Compared to other types of drugs, CAR-Ts require strict manufacturing and administration adherence, which made their development resource- intensive and expensive. As such, their development in different parts of the world was stymied by the need to make large upfront investments in R&D, manufacturing, and scientific expertise to build a CAR-T-friendly ecosystem. Once the initial foundation was laid, data indicates that China sped ahead to employ this therapeutic approach. Between 2010 and 2014, GlobalData identified around 90 CAR-Ts in development, and in 2021 that number had increased to over 300.
Bringing innovative therapies into focus As part of Healthy China 2030, and other pharma and healthcare visionary programmes, the country enhanced its focus on innovative therapies, says Sasmitha Sahu, a pharma analyst at GlobalData. There has been an influx of investments recently, as illustrated by the fact that from 2018 to 2021, domestic Chinese cell therapy companies have raised approximately $2.4 billion, says Lu, who is also medical executive president at Lu Daopei Hospital in Beijing. David Deere, an operational pharma consultant with expertise in China’s reimbursement landscape, also points to the Made in China 2025 policy – a 10-year national strategic plan to develop the manufacturing sector – as key to this domestic-focused approach to developing therapies. Healthcare, in addition to other sectors, has received significant investments in this regard, he says. On average, the number of newly identified CAR-T therapies from Chinese developers has doubled every year since 2014. Deere says the scale of CAR-T-related
investigations is unsurprising. “It takes a village to do a CAR-T trial and large hospitals have their own experienced team with investigators and nurses who are eager to participate and open such studies, which has accelerated this research,” adds Lu. In China, Deere says, large first-tier hospitals
are a world and governments unto themselves, and CAR-T development in that kind of an
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