Emirati leads charge to reduce cost of one of world's most expensive cancer treatments

An Emirati doctor who found himself on the front lines against Covid-19 in the US during the pandemic is on a mission to change cancer care in the UAE . Dr Ajlan Al Zaki is now based at Burjeel Hospital in Abu Dhabi , having worked at Stanford University's hospital in California, where he played a major role in the fight against Covid-19. Now he is leading a project to help reduce the cost of one of the most expensive cancer treatments by up to 90 per cent. Although the UAE offered to repatriate its citizens from the US during the pandemic, Dr Al Zaki refused to leave his post at Stanford. “I’ve been in the US for a long time, and I felt like I got enough experience where I felt comfortable enough to transplant that knowledge to the UAE," Dr Al Zaki told The National . “It’s exciting to be part of building something in a country that’s relatively young, but has accomplished so much in a short amount of time.” CAR T-cell therapy, short for chimeric antigen receptor T-cell therapy, is a type of immunotherapy that collects a patient’s blood, isolates their T-cells - specialised immune cells - modifies them in a lab so they can recognise and attack cancer, and then reinfuses them back into the patient, essentially reprogramming the immune system to become a personalised weapon against cancer. Globally, CAR T-cell therapy is one of the most expensive forms of cancer treatment currently available. In the US, costs for a single treatment cycle, including admission to hospital, immune cell collection, lab engineering, infusion, and management of side effects, can exceed $1.5 million. Even the baseline cost of the CAR-T product alone typically ranges between $475,000 and $650,000, depending on the cancer type and manufacturer. Burjeel Holdings aims to overcome this challenge by producing CAR-T therapies locally. It is projected to reduce treatment costs by up to 90 per cent compared to the US and Europe. Dr Al Zaki’s specialisation lies in treating blood cancers such as lymphoma, leukaemia and multiple myeloma. After earning a PhD in bioengineering from the University of Pennsylvania, he completed his medical degree at George Washington University, followed by internal medicine training at Stanford and a haematology-oncology fellowship at MD Anderson Cancer Centre in Houston - one of the world’s leading institutions of its kind. He is the first and only Emirati doctor to specialise in cellular cancer therapy. Yet he downplays the title, preferring to focus on the work rather than accolades. “I don’t think of it as first or second,” he said. “I just think of it as how can you help in any way possible? How can you give a small piece of what you know and give back to society. I’m just playing my part.” Success is "being able to give something back and never expect anything in return”, he added. “That’s what excites me the most, sharing knowledge and inspiring more people to join the fight against cancer.” Although he rejects personal recognition, he says he is deeply proud to represent his country in a field so vital to the future of medicine. “It’s an honour,” he said. “But the most important thing is what we build for the generations that follow.” CAR T-cell therapy is typically offered only after other treatments, such as chemotherapy, with global trials exploring moving it to first-line use. "That would be the dream, right? Chemo-free treatment. Immunotherapy," Dr Al Zaki said. “In the US, for one patient, one single infusion can cost several hundred thousand dollars - around $500,000 for just the infusion itself. “That doesn’t even take into account hospitalisation, toxicities, or medications to treat those toxicities. The total cost can easily go above $1 million per patient." There are opportunities to make CAR T-cell therapy available on a large scale by decentralising the manufacturing process, Dr Al Zaki added. “We would basically manufacture the CAR T-cells locally. That would significantly cut down the cost,” he said. Rather than shipping patient cells abroad for processing, Dr Al Zaki hopes to set up a lab in the UAE to perform the entire process domestically. In 2023, Abu Dhabi Stem Cell Centre (ADSCC), a subsidiary of Pure Health, successfully manufactured the UAE’s first CAR-T cells to treat an 11-year-old boy with leukaemia. “It would be exciting to bring down the cost of CAR T-cell therapy … or a collaborative opportunity in the UAE would be something very beneficial," he said. "The technology is out there, the knowledge is out there. If we do the programming ourselves, you already cut down the cost by several hundreds of thousands of dollars.” While CAR T-cell therapy is currently used to treat blood cancers, researchers including Dr Zaki are exploring ways to expand its reach to solid tumours. He also wants to see the UAE become a centre for clinical trials and specialised expertise. “We have amazing specialists here,” he said. “But I think we’re still limited when it comes to rare subtypes of cancer. Rather than seeing a broad range of diseases, we need more doctors who focus on very specific cancers, like just T-cell lymphoma, for example.” Dr Zaki’s journey into oncology was inspired by academic discovery and personal experience. Initially drawn to chemical engineering, he moved to cancer research while in college after working with a mentor to develop cancer-detecting nanoparticles. But the turning point came when his grandfather was diagnosed with cancer - twice. “I spent six weeks driving him daily from Abu Dhabi to Al Ain for radiation therapy,” he said. “Later, when I was doing my PhD at UPenn, he got a different kind of cancer and had to go to MD Anderson in Houston. I never knew I would end up working there.” That experience made him want to move beyond research and work directly with patients. “I wanted to be that person who would develop something and take it to patients when they needed it so desperately,” he said. He describes cellular therapy as the perfect intersection of his interests. “It brings together engineering, biology, and oncology,” he said. “It lets me use all parts of my background to help patients and at the end of the day, that's all I want to do." Dr Zaki also hopes to bridge the gap between hospitals and academia. “In five years, I’d like to see a low-cost CAR T-cell programme delivering outcomes comparable to the West,” he said. “But I also want to see a collaborative ecosystem between hospitals and research institutions—where we share knowledge, accelerate innovation, and introduce new technologies and therapies to our healthcare system.”

Emirati leads charge to reduce cost of one of world's most expensive cancer treatments

Dr Ajlan Al Zaki plays role in plan to cut price of CAR T-cell therapy by up to 90 per cent