#Interviews
#Interviews
08.07.2026
Brazil a potential global leader in cell and gene therapies, says Martin Bonamino
INCA researcher discusses the challenges of using CAR-T cells, how access could be expanded through Brazil’s public health system (SUS), and the potential of gene editing to transform medicine
"Gene editing is key to the creation of universal cells and its development could be accelerated by AI tools," says Martin Bonamino, head of the Cellular and Gene Immunotherapy Program at Brazil’s National Cancer Institute (INCA) | Image: Personal Archive
Supported by the Ministry of Health, Brazil has the capacity to coordinate domestic initiatives few countries can match in the field of cell and gene therapies, including the production of critical inputs. This advantage could make the country more competitive, with the potential to take a leading role in the development of advanced treatments, according to biologist Martin Bonamino, head of the Cellular and Gene Immunotherapy Program at Brazil’s National Cancer Institute (INCA), president of the Brazilian Association of Cell and Gene Therapy, and chair of the Outreach Committee of the American Society of Gene & Cell Therapy.
One of the most important advances in this field is the emergence of CAR-T cell therapies, in which immune cells are modified in a lab to recognize and attack cancer.
The approach has achieved significant results in the treatment of certain blood cancers, including leukemia, lymphoma, and multiple myeloma.
There are still obstacles to wider adoption, however, such as the duration of the treatment response, its effectiveness against solid tumors, and high production costs. The latter is especially relevant when it comes to making use of the technology in the public health system.
In an interview with Science Arena, Bonamino discussed how the effectiveness of CAR-T therapies can be prolonged and expanded, their prospects for treating solid tumors, and Brazil’s potential to develop and produce advanced therapies.
He also talked about strategies for expanding access to these treatments and explained why he sees gene editing as one of the technologies with the greatest potential to transform medicine in the years ahead.
Science Arena – CAR-T therapies have transformed the treatment of several blood cancers. What are the biggest challenges to improving and extending these results and replicating them in solid tumors?
Martin Bonamino – With blood cancers, one of the main challenges is that CAR-T cells do not always remain in the body long enough to eliminate all the tumor cells. This is related to the quality of the T cells collected from the patient to manufacture the therapy.
Since these patients have often already undergone multiple other treatments, their cells may be less functional. One way to avoid this problem is to harvest cells earlier or obtain them from healthy donors.
Another resistance mechanism arises when tumor cells stop expressing the target recognized by the CAR-T cells, effectively becoming invisible to the immune system. This can be overcome by developing CAR-T cells capable of recognizing more than one tumor target.
In solid tumors, these challenges are compounded by the fact that the tumor’s own microenvironment often blocks the activity of antitumor lymphocytes. Additional modifications could make CAR-T cells more resistant to these defense mechanisms.
Initial results are promising, but the success rates remain lower than those seen in blood cancers.
Could Brazil become a leading player in the development of cell and gene therapies, or is it still too reliant on technologies produced abroad?
Brazil has the capacity to develop and produce advanced cell and gene therapies. Our dependence is less on technologies developed abroad and more on inputs produced overseas.
There are no domestic equivalents for many of these materials, which are expensive and often take a long time to arrive at destination in Brazil after being purchased. This undermines the country’s competitiveness when it comes to developing new therapies.
However, with the support of the Ministry of Health, Brazil has the capacity to orchestrate domestic initiatives that few countries are able to match, including the production of critical inputs for these advanced therapies. This could make Brazil more competitive in the field, placing it in a prominent position on the global stage.
What is the biggest obstacle to expanding access to CAR-T therapies and making them available to a larger number of patients?
Right now, there are several major challenges. The first is the amount currently charged to prepare this therapy for each patient. Brazil’s response has been to produce the treatment locally at specialized centers.
“This approach has the potential to make the therapy available at an affordable cost through Brazil’s public health system (SUS), helping to remove one of our main hurdles.”
What do we currently know about the cost-effectiveness of cell therapies?
Despite current commercial prices, these therapies have a highly favorable safety profile, low toxicity levels, and positive clinical outcomes. Treatments such as CAR-T cell therapy are expensive, but they also result in fewer complications (meaning potentially lower overall costs) than more aggressive therapeutic alternatives, such as bone marrow transplants.
The lower production cost and potentially greater anti-cancer potency of more recently manufactured CAR-T cells are further improving their cost-effectiveness through lower prices and better outcomes.
Can cellular models and gene-editing technologies help scientists better understand other diseases beyond cancer?
Absolutely. Gene-editing technologies are now among the most important tools for studying diseases. They allow researchers to create biological models that reproduce disease conditions in a laboratory and to evaluate whether gene therapies in development could benefit patients with genetic disorders.
This quick and direct way of understanding a disease and testing possible solutions is revolutionizing medicine.
Between gene editing, universal cells, and artificial intelligence, which technology has the greatest potential to transform biomedical research and clinical practice in the coming years?
I believe that gene editing will be the key factor among them. It is fundamental to the creation of universal cells, and its development could be accelerated by artificial intelligence.
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