Pioneering CAR-T therapy made available on NHS for adults with lymphoma
A ground breaking new type of treatment that uses the immune system to fight cancer will be made available on the NHS in England for adult lymphoma patients, it has been announced.
Patients with two types of blood cancer, diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma (PMBCL), who relapse after two or more different types of treatment, will now be able to access the CAR-T therapy Yescarta through the Cancer Drugs Fund (CDF).
These patients currently have an extremely poor chance of survival when treated with further intensive chemotherapy, which until now has been standard treatment in the UK.
Clinical trials have shown that Yescarta could provide a long term cure for four out of 10 of these patients.
CAR-T cell therapies work by taking samples of immune cells from the patient and genetically modifying them in a laboratory to recognise, seek out and kill cancer cells, before putting them back into the patient’s blood system.
CAR-T therapy is designed to be a one-off treatment and is thought to have the potential to give patients a life-long ‘immunity’ to their cancer.
DLBCL is the most common form of blood cancer, diagnosed in around 5,000 people each year in the UK. PMBCL is much rarer, with up to 300 people affected a year. It is estimated that around 200 patients with these lymphomas will benefit from Yescarta each year.
NHS England has announced that the first hospitals to provide CAR-T therapy will be in Birmingham, Bristol, London, Manchester and Newcastle. It expects that the centres will be ready to treat patients within weeks.
Bloodwise was one of the patient organisations that has be consulted in NICE’s appraisal process for Yescarta.
Dr Alasdair Rankin, Director of Research and Patient Experience at the blood cancer charity Bloodwise, said: “CAR-T therapies have shown huge promise in treating patients with lymphoma who have no other chance of cure. It’s admirable that the NHS and the pharmaceutical company have worked hard to make this pioneering treatment available so quickly, giving hope to current patients and their families.
“The next big challenge for the NHS will be to deliver this new and complex treatment on a scale that ensures access for the hundreds of patients with these lymphomas who could benefit from CAR-T therapy each year.
“It is likely that we are only beginning to see the benefits that CAR-T therapy can bring. Treatments will continue to improve and become more effective over the coming decade and will benefit patients with other types of cancer.”
Yescarta was provisionally turned down for use on the NHS in August but NICE has reversed its decision after hearing more evidence on its effectiveness and agreeing a price for the treatment with its manufacturer, Gilead.
CAR-T therapy is very expensive. Yescarta has a list price of around £300,000 per patient but the NHS will receive a discount on this price.
A final decision on a similar CAR-T drug called Kymriah, also for the treatment of DLBCL, is expected soon.
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