NICE recommends revolutionary CAR T-cell therapy for adults with lymphoma

Patients diagnosed with diffuse large B-cell lymphoma are to be offered a revolutionary treatment.

The National Institute for Clinical Excellence (NICE) has updated it’s guidance to recommend the use of revolutionary chimeric antigen receptor T-Cell (CAR T-cell) therapy for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

There were 11,690 new cases of non-Hodgkin lymphoma (NHL) in England in 2015 with 4,688 of these being diffuse large B-cell lymphoma.

Tisagenlecleucel, also known as Kymriah and made by Novartis, is will be recommended for adults with relapsed or refractory DLBCL. It will also be offered to people whose disease has not responded or those whose disease has relapsed after treatment with two or more courses of chemotherapy.

CAR T-cell therapies are specifically manufactured for each individual patient. This involves taking some of the patient’s own white blood cells which are then reengineered in a laboratory so they can recognise and attack cancer cells before being infused back into the patient.

An estimated 200 people will be eligible for treatment each year.

The list price for tisagenlecleucel is £282,000 and it is given as a single intravenous infusion. The company have agreed to offer the therapy at a confidential discounted price. It is estimated 200 people will be eligible for treatment each year in the UK and NHS England are working closely with several hospitals across the country to deliver this complex treatment.

Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE said: “Recommending another revolutionary CAR T-cell therapy for adults with lymphoma represents a step forward for personalised medicine. We are pleased that patients are set to benefit from such an innovative therapy so rapidly because of joint working between NICE, NHS England and the company.

“CAR T-cell therapy is expensive, however the treatment is specific to each individual and could be a potential cure for some, although it is early days. Our recommendation for tisagenlecleucel on the Cancer Drugs Fund means people can benefit while more data is collected.”

Dr Alasdair Rankin, Director of Research and Patient Experience at the blood cancer charity Bloodwise, said: “CAR T-cell therapy is the most promising breakthrough in blood cancer treatment of the past decade, with the potential to be used much more widely in the future.

“Ensuring access to CAR T-cell therapies gives these patients the real chance of long-term survival when all other treatments have failed.”