Democratising Cancer Care: In Conversation with Dr. Jasmeet Sidhu, Punjab's Pediatric CAR-T Pioneer

Image: Dr Jasmeet Sidhu, Homi Bhabha Cancer Hospital & Research Centre, Punjab

Punjab has achieved a significant medical milestone with the successful treatment of a 15-year-old leukaemia patient using CAR-T cell therapy—the first such procedure in the state.

A clinical team led by Dr. Jasmeet Sidhu at the Homi Bhabha Cancer Hospital & Research Centre carried out the landmark treatment, signalling that advanced, world-class cancer care driven by homegrown innovation is increasingly within reach in India. We sat down with Dr. Jasmeet Sidhu to understand the story behind this case and the road ahead.

Q1. Dr. Sidhu, you have dedicated your career to treating children with cancer. What drew you to paediatric oncology, and how would you describe the team and capabilities you have built at HBCHRC?

Paediatric oncology chose me as much as I chose it. When I was a resident, I rotated through the children’s ward and I saw something that changed me - the absolute trust a sick child places in you, and the extraordinary resilience they show in the face of something so overwhelming. That combination of vulnerability and courage is humbling. It made me want to dedicate everything I had to this field.

At Homi Bhabha Cancer Hospital & Research Centre, we have been deliberate in building a team that mirrors that spirit. We have paediatric haematologists/oncologists, intensivists, transfusion medicine team, nurses trained in cellular therapy management, and a dedicated psychosocial support team. We have built an entire ecosystem where a child from any background, walking through our doors, receives care that is comparable to the best in the world.

Q2. Your centre recently made national headlines for treating a 15-year-old leukaemia patient using a made-in-India CAR-T cell therapy. Walk us through that case: the relapse, the decision to use CAR-T, and what this milestone means for your team and for patients who might follow in this child's footsteps.

This young patient had been diagnosed with B-Cell Precursor Acute Lymphoblastic Leukaemia (BCP-ALL) in Haryana and received frontline chemotherapy. But while on treatment, patient had combined CNS and bone marrow relapse. That is a particularly difficult clinical scenario. Very early relapse in BCP-ALL carries a grim prognosis with conventional salvage chemotherapy. The window for cure narrows dramatically.

When we evaluated this child, the multidisciplinary team agreed that CAR-T cell therapy, using an indigenous, made-in-India CD19-directed product, offered the best chance of achieving a durable remission. We had the infrastructure, the expertise, and critically, access to a high-quality Indian CAR-T product that made this financially and logistically feasible for the family.

After bridging chemotherapy to reduce tumour burden, we collected the patient’s T-cells, sent them for manufacturing, completed lymphodepletion conditioning, and infused the CAR-T product. The team monitored the patient around the clock through the critical post-infusion period. We saw the response, a deep MRD remission, and then watched this young person walk out of the hospital with their family. This made all the effort worthy.

Q3. The patient is just 15 years old. How significant is it that CAR-T therapy is now reaching paediatric patients in India, and what makes a young patient like this a suitable — or perhaps even ideal — candidate for this treatment?

For paediatric patients, their immune systems are more robust and more plastic than adults’, which means the engineered T-cells engraft and expand more effectively. The biology of paediatric BCP-ALL, with its near-universal CD19 expression on leukaemic blasts, makes it a very well-matched target for CD19-directed CAR-T products. Currently, CAR-Ts are approved for children ≥15 years of age. Clinical trial testing its efficacy in 1–15-year-old has just been completed.

Beyond the biology, there is the moral dimension. A 15-year-old who relapses very early has decades of life ahead of them - if we can get them into deep remission. The stakes could not be higher. The fact that this therapy is now available in Punjab, at our centre, means a family in this region does not have to choose between selling everything they own to travel abroad, or watching their child run out of options. That is a profound shift.

Q4. HBCHRC is a young institution, yet your team is now delivering some of the most advanced therapies available in cancer medicine. What has it taken to build that level of capability here, and what are the remaining gaps you are working to close?

Building this capability has required years of preparation on multiple fronts simultaneously. We invested in a dedicated haemato-oncology unit with the nursing protocols, monitoring systems, and pharmacy infrastructure needed to manage CAR-T patients safely - particularly the management of Cytokine Release Syndrome and neurotoxicity, which require specialised expertise.

We worked closely with our institutional leadership, and with the manufacturer of the indigenous CAR-T product to ensure every process met the highest standards. HBCHRC may be a young institution by calendar age, but the people here came with years of experience, and we have moved quickly because we had a clear vision from day one: to be a centre that does not just treat cancer but advances how cancer is treated in this country.

We want to expand our cellular therapy capacity, build a stronger biobank, and deepen our outcome tracking so we contribute meaningfully to the evidence base for Indian patients. Access to CAR-T must also extend beyond those who can reach us easily - outreach, referral networks, and financial support mechanisms all need to grow.

Q5. A comparable CAR-T therapy abroad can cost upwards of ₹3 crore. How does an indigenous CAR-T therapy like the one administered to your patient fundamentally change the equation for an Indian family that is facing blood cancer today?

The cost differential is staggering - and it is life-or-death staggering. At INR 3 crore or more abroad, CAR-T therapy is simply inaccessible for most Indian families. The indigenous CAR-T product we used changes that equation fundamentally. The cost comes down to a fraction of what is charged internationally, and the logistics are entirely different - no international shipping, no regulatory delays, no currency exchange burden on a family already under immense financial and emotional stress.

When a family comes to us devastated by their child’s relapse, the last conversation I want to have is about money. The development of made-in-India CAR-T is not just a scientific achievement - it is an act of equity. It says that a child born in Punjab has the same right to cutting-edge cancer treatment as a child born in London or New York. That is the India we should be building.

Q6. Finally, looking ahead — what are your plans for scaling CAR-T at this centre? Are you looking at more paediatric cases, along with adults? And what would it take to make this a routine treatment option across North India?

Our plans are ambitious and grounded. We are actively building our CAR-T programme to treat more paediatric patients, but we are also preparing to extend to adult patients with relapsed/refractory B-cell malignancies, including diffuse large B-cell lymphoma and other CD19-positive haematological cancers.

For North India specifically, I believe we have a responsibility to become a regional hub. We are engaging with referring physicians across Punjab, Haryana, Himachal Pradesh, and Jammu & Kashmir to ensure that when a patient has a very early relapse, they are referred here promptly rather than losing precious time. Speed matters enormously in CAR-T as the patient must be fit enough to undergo the process.

To make this truly routine, three things need to happen: first, more centres need to develop this capability so no single point of failure exists; second, government and insurance frameworks must incorporate CAR-T into coverage schemes; and third, the manufacturing ecosystem for indigenous products needs to scale. I am optimistic about all three. What happened at HBCHRC is the beginning of a much larger story for Indian oncology.