CAR-T therapy could be available to NHS patients this year

NHS England chief executive Simon Stevens has indicated that chimeric antigen receptor T-cell therapy (CAR-T) could be available on the NHS this year, offering eligible patients a ‘ground-breaking’ approach to treating cancer.

Addressing the Association of the British Pharmaceutical Industry’s annual conference in London, he said "preparations are underway to make CAR-T, one of the most innovative treatments that has ever been offered on the NHS available to patients."

But he also stressed manufacturers "need to set fair and affordable prices so treatments can be made available to all who need them."

"This is a really positive step for some people living with cancer whose lives cannot be saved using the treatments doctors can already provide," said Dr Alasdair Rankin, director of research at the leading UK blood cancer charity Bloodwise, welcoming the announcement.

However, he also cautioned: "These therapies are expensive, and in order for them to become widely available, manufacturers need to set fair prices so that they are both affordable and sustainable in the long term."

CAR-T therapy offers a new treatment approach in that it is specifically manufactured for each individual patient. During the process, T cells are drawn from a patient's blood and reprogrammed in the lab to create T cells that are genetically coded to hunt the patient's cancer cells.

The first CAR-T therapy is yet to be approved in Europe, but a regulatory green light will only be the first hurdle to securing patient access; while they are effective, the therapies are expected to be very expensive and are complicated to administer.

"There is a whole body of work being done to draw up service specifications for centres in the UK at NHS hospitals to determine what the requirements are to deliver this kind of therapy to patients, because they are very complex," Emma Morris, professor of clinical cell and gene therapy at University College London, told the Guardian.

"Currently we are only delivering them [in clinical trials] in two or three centres in the UK and run by transplant teams used to giving cell therapies."

Kite Pharma submitted the first CAR-T cell therapy for review in Europe, seeking permission to market its axicabtagene ciloleucel (axi-cel) to treat patients with three subtypes of aggressive non-Hodgkin lymphoma (NHL).

EU regulators are also reviewing Novartis’ CAR-T therapy CTL019 (tisagenlecleucel) for children and young adults with relapsed or refractory (r/r) B-cell acute lymphoblastic leukaemia (ALL) and for adult patients with r/r diffuse large B-cell lymphoma (DLBCL) who are ineligible for autologous stem cell transplant.

"As we celebrate the 70th anniversary, the NHS is working harder than ever to save lives and improve care by embracing cutting edge technology like CAR-T therapy and spreading innovation across the whole health service," Stevens said.

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