NexCAR19 (generic name actalycabtagene autoleucel) is India's first approved CAR-T cell therapy. It was developed by IIT Bombay and Tata Memorial Centre, is made by ImmunoACT, and was cleared by India's drug regulator, the CDSCO, in October 2023 for relapsed or refractory B-cell lymphoma and leukaemia[c1]. It is given as a single infusion of your own re-engineered T-cells. This page covers who can receive it, what the trials showed, what it costs, how long the process takes, and where to ask about it.
Medical disclaimer: This content is for general awareness and does not replace a doctor’s consultation. For diagnosis or treatment decisions, consult a qualified specialist.
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NexCAR19 at a Glance
| Question | Answer |
|---|
| What is it? | A CD19-targeted CAR-T cell therapy. Your T-cells are collected, modified in a laboratory to recognise the CD19 protein on B-cells, and infused back[c1] |
| Who makes it? | ImmunoACT, a company incubated at IIT Bombay, with Tata Memorial Centre running the clinical trials[c1] |
| Regulatory status | Approved by the CDSCO in October 2023, India's first approved CAR-T therapy[c1] |
| What it treats | Relapsed or refractory B-cell non-Hodgkin lymphoma and B-cell acute lymphoblastic leukaemia (B-ALL)[c2] |
| How it is given | A single-dose infusion, about 20 days from cell collection to infusion according to the manufacturer[c3] |
| Indicative cost for international patients | ₹34–48 lakh (about $35,000–$50,000); see the cost section for what that covers |
If you are comparing NexCAR19 with CAR-T products sold in the US, our CAR T-cell therapy guide sets the two trials side by side, and the CAR-T cost page explains the price range in more detail.
Who Can Receive NexCAR19
NexCAR19 is not a first-line treatment. It is for people whose B-cell cancer has come back after treatment (relapsed) or did not respond to it (refractory)[c2]. The manufacturer's patient guide lists these checks before a hospital goes ahead[c2]:
- Cancer type: B-cell non-Hodgkin lymphoma (for example large B-cell lymphoma) or B-cell acute lymphoblastic leukaemia.
- CD19 on the cancer cells: the laboratory must confirm the cancer carries the CD19 marker, because that is what the cells are built to find.
- Age: the guide notes that some CAR-T therapies are approved from age 15, and a hospital announcement for NexCAR19 described patients aged 15 and above[c4]. Ask the treating team to confirm the age limit that applies to you.
- Previous treatment and response: what you have already had, and how the cancer responded.
- Overall health: heart, liver and kidney function, any current infection, and how well you manage day-to-day activities.
Whether you qualify is decided by the CAR-T team after reviewing your reports and, usually, new tests. We cannot decide it for you, but we can put your reports in front of the right team early (see below).
What the Trials Showed
NexCAR19 was approved on the strength of two small trials in India that together included 64 people with advanced lymphoma or leukaemia[c1]. Results presented at the American Society of Hematology meeting in December 2023 covered the 53 patients who could be evaluated (38 with lymphoma and 15 with leukaemia). Overall, 36 of the 53 (67%) responded, and the cancer disappeared altogether in about half[c1]. By group:
| Result | Lymphoma (38 patients) | Leukaemia (15 patients) |
|---|
| Responded to treatment | 26 of 38 patients (68%) | 10 of 15 patients |
| Type of response | Not broken down in the source | Every response was a complete response (no sign of cancer) |
Across the 53 patients, about 5% had a severe form of cytokine release syndrome (an immune over-reaction), none had the neurological side effects often seen with CAR-T products approved in the US, and only five patients needed hospital admission because of side effects[c1].
How much weight to give these numbers. The trials were small and were funded by ImmunoACT, the company that makes the product[c1]. The sources used for this page do not report five-year survival for NexCAR19, so we do not quote one. A response is not a cure: some people who respond relapse later. Ask the treating team for the latest published follow-up before deciding.
NexCAR19 Cost in India
In the US, a CAR-T infusion costs about $400,000. At the December 2023 presentation, NexCAR19 was expected to cost around $50,000[c1]. Our reference range for an all-inclusive package for international patients at an accredited private hospital is ₹34,00,000–₹48,00,000 (about $35,000–$50,000).
About these prices: all-inclusive package estimates for international patients at accredited private hospitals, compiled in September 2026 from published hospital and facilitator price lists (about ₹96 per US dollar). Indian residents are usually quoted lower domestic tariffs; your final cost is confirmed after a specialist reviews your reports.
What decides where you land in the range
- The hospital, and the length of stay it expects for you.
- Whether you need an intensive-care stay to manage cytokine release syndrome or other side effects.
- Tests and bridging treatment before cell collection, such as chemotherapy to keep the cancer in check while your cells are made.
- How long you stay near the treatment centre afterwards: the manufacturer's guide says four weeks or more after infusion[c2].
Financing
ImmunoACT's patient guide describes bridge financing of up to ₹10,00,000 at 0% interest over 12 months and philanthropic access programmes[c2]. The guide does not say whether international patients qualify, so ask the hospital before counting on them.
Treatment Timeline: 6 to 10 Weeks
The manufacturer's guide describes a process of roughly six to ten weeks from referral to the end of the monitoring period[c2]:
- Referral and assessment: the CAR-T team reviews your reports and tests whether you qualify.
- Cell collection (apheresis): a 4–6 hour outpatient procedure that collects your T-cells.
- Cell preparation: about three to four weeks in the laboratory. This is the longest wait.
- Pre-infusion chemotherapy: about three days in hospital, to make room for the new cells.
- Infusion: a single intravenous infusion that takes under an hour.
- Monitoring: time in hospital first, then four or more weeks staying near the treatment centre so the team can act fast on side effects.
The manufacturer states about 20 days from apheresis to infusion[c3], so the exact wait depends on the hospital's schedule and your case.
Where NexCAR19 Is Given
ImmunoACT says it works with more than 130 cancer hospitals across India and runs a treatment-centre finder on its website[c3]. Two centres we can name from published sources:
- Tata Memorial Hospital, Mumbai. The first patient received NexCAR19 here on 4 June 2021 in the clinical trial[c1].
- Cytecare Hospitals, Bengaluru. Announced in February 2024 that it would offer NexCAR19[c4].
Which centres hold stock, have a free slot and accept international patients changes month to month. Confirm directly before you plan travel. That is one of the things we do for you.
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Risks and Side Effects
The manufacturer's guide lists these common effects[c2]: fever and fatigue, low blood pressure, neurological symptoms such as confusion or difficulty speaking, reduced immunity, temporary changes in blood counts, and, less commonly, difficulty breathing. Cytokine release syndrome is the best-known risk of CAR-T in general, and it is why the monitoring period matters.
Contact the clinical team or go to emergency care straight away if you develop a high fever (38°C or above), confusion or sudden difficulty speaking, or difficulty breathing[c2]. This is also why you stay near the hospital for the first weeks.
Planning Treatment from Abroad
- Time: expect to be in India for the collection visit and, after the cells are made, for the infusion and at least four weeks of monitoring. Ask the centre how it schedules the visits.
- Visa: a medical visa needs a letter from the hospital. Our guide to the e-Medical visa for cancer treatment in India explains the attendant visas and the documents.
- Companions: you will need someone with you during monitoring, and the visa rules allow two attendants.
- Other options: if CAR-T is not suitable, a stem cell transplant may be. Read our bone marrow transplant guide.
Frequently Asked Questions About NexCAR19
Is NexCAR19 approved in India?
Yes. The CDSCO approved it in October 2023 for relapsed or refractory B-cell lymphoma and leukaemia, making it India's first approved CAR-T therapy[c1].
How much does NexCAR19 cost?
For international patients our reference range is ₹34–48 lakh (about $35,000–$50,000) all-inclusive at an accredited private hospital. A US CAR-T infusion costs about $400,000[c1]. Your own quote depends on the hospital and on whether complications need intensive care.
Which cancers can NexCAR19 treat?
Relapsed or refractory B-cell non-Hodgkin lymphoma and B-cell acute lymphoblastic leukaemia whose cells carry CD19[c2]. It is not used for solid tumours such as breast, lung or prostate cancer.
How effective is NexCAR19?
In the Indian trials, 36 of 53 evaluable patients (67%) responded: 26 of 38 with lymphoma and 10 of 15 with leukaemia, with every leukaemia response complete[c1]. These were small trials with limited follow-up, so they cannot tell you how long responses last.
How long does the whole process take?
About six to ten weeks from assessment to the end of monitoring, with roughly 20 days from cell collection to infusion[c2][c3].
Can foreign patients get NexCAR19?
Some centres treat international patients, but availability varies. Send us your reports and we will ask the centres which of them can take your case and when.
Is NexCAR19 the same as the CAR-T used in the US?
No. Like most US-approved products it targets CD19, but it is a different product made in India, tested in different trials[c1]. The numbers from the two cannot be compared head to head.
What happens if NexCAR19 is not suitable?
The team will discuss other routes, such as further chemotherapy, a stem cell transplant, or another clinical trial, depending on your cancer and how it has behaved.
Discover the Best Oncologists and Cancer Hospitals in India
When it comes to cancer treatment, finding the right specialist and hospital can make a significant difference in the outcome. In this blog, we have compiled a list of the top oncologists and cancer hospitals across major cities in India, ensuring that you have access to the best care available.
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For those seeking expert oncologists, we have identified the best specialists in key cities:
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In addition to finding the right specialist, choosing the right hospital is crucial for comprehensive cancer care. Here are the top hospitals in major cities:
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Conclusion
Finding the right oncologist and hospital is the first step in your cancer treatment journey. Explore the links above to learn more about the top specialists and hospitals in your area.
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