Cancer breakthrough as ‘pioneering treatment’ gets NHS approval

Blood cancer: Symptoms explained by healthcare professionals

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Thousands currently living with blood cancer could soon be offered a lifeline, as a “pioneering” treatment has been given the green light for use in the NHS. The first-of-its-kind CAR-T therapy will be offered to hundreds of people living with the condition and will help their own immune systems to fight off lymphoma. Up to 450 people with an aggressive form of lymphoma are set to benefit from the first personalised immunotherapy treatment to be recommended for routine use in the NHS. This treatment involves modifying a patient’s immune cells so that they attach to and kill cancer cells.

Axicabtagene ciloleucel (Yescarta, Kite) is a CAR-T therapy for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL) who have had two or more lines of systemic therapy.

CAR-T therapy, which stands for chimeric antigen receptor T-cell, is administered as a one-off intravenous infusion and has been hailed as a “one-size-fits-all” cancer treatment in the future.

Today, the National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending the treatment be made routinely available on the NHS for suitable patients.

It was previously available through the Cancer Drugs Fund and will be commissioned routinely to patients in England after the NHS Commercial Medicines Directorate struck a confidential commercial deal with the company.

Before making the recommendation, NICE’s independent appraisal committee considered new evidence, including data from a clinical trial and from people having axicabtagene ciloleucel through the Cancer Drugs Fund (CDF).

The data they saw suggested that people having axicabtagene ciloleucel live longer than people having chemotherapy and have longer before their condition gets worse.

Helen Knight, director of medicines evaluation, at NICE, said: “I am delighted that we have been able to recommend this pioneering treatment for people.

“The evidence from its use in the CDF and clinical trials shows it can offer an effective treatment, helping people live longer and with a better quality of life. This news illustrates how NICE is determined to get the best care to patients fast, while ensuring value for money for the taxpayer.”

A total of 318 people received treatment through the CDF between December 2018 and October 2021 in England.Overall survival rates in the CDF, with data collected over 36 months, show the median overall survival of people having axicabtagene ciloleucel was 28.5 months and 45 percent of people were alive after three years.

Currently, there is no standard treatment for relapsed or refractory diffuse large B-cell lymphoma or primary mediastinal large B-cell lymphoma after two or more systemic therapies.

Best supportive care usually includes salvage chemotherapy, which is given after the cancer has not responded to other treatments. Meanwhile, NICE estimates that the median overall survival on salvage chemotherapy is around 6.4 months.

According to Blood Cancer UK, over 10,000 people are diagnosed with a type of non-Hodgkin lymphoma (NHL) every year in the UK. Of these, around one in three have diffuse large B-cell lymphoma (DLBCL).

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While DLBCL most commonly affects those that are 65 and older, NICE warned that the disease can develop at any age.

NHS England’s Director of Specialised Commissioning and interim Commercial Medicines Director, John Stewart said: “Five years ago the NHS led the way in Europe by striking commercial deals for revolutionary CAR-T cancer treatment and today we have used our commercial capabilities to reach a deal that secures long-term patient access to this personalised therapy.

“This advanced therapy has been commissioned through the Cancer Drugs Fund since 2018, allowing evidence to be collected that confirms its benefits for patients facing this aggressive form of lymphoma and now enables the NHS to provide routine access at a fair price for taxpayers.”

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