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CAR T-cell therapy

 

CAR T-cell therapy is a treatment where a patient’s T-cell lymphocytes (a type of immune system cell) are taken from a patient’s blood.

The T-cells are then changed in the laboratory, where a special receptor gene called a chimeric antigen receptor (CAR) that binds to a certain protein on a patient’s cancer cells is added. Large numbers of the CAR T-cells are grown in the laboratory and given to the patient as a one-time infusion. The CAR T-cells then find and attack the cancer cells. 

CAR T-cell therapy has been successful in the treatment of some blood cancers, including some types of lymphoma.

T-cell lymphocytes are a type of white blood cell that circulate around our bodies and are an important part of our immune system. T-cells scan for infection and abnormal cells throughout the body, including cancer and attack to kill these cells. They also help in the process for our immune system to remember these cells for future protection.

As from the 19 December 2018, it was announced that the Therapeutic Goods Administration (TGA) has approved Novartis’ KYMRIAH CAR T-cell therapy in Australia. Patient access has been approved for the use in adult patients with Diffuse Large B-cell lymphoma (DLBCL) who have refractory or have relapsed disease after two or more lines of conventional therapy and paediatric and young adult patients (up to 25 years old) with B-cell precursor acute lymphoblastic leukaemia (ALL).

The Medical Services Advisory Council are currently considering funding through the Medical Benefits Schedule and governments are currently discussing ways to provide funding and access to patients through the public health system, with costs of $598,000 per patient. 

Current access for lymphoma patients, from the 19th December 2018:

  • Peter MacCallum Cancer Centre – clinical trial open for patients with high risk relapsed Follicular Lymphoma (FL)

Clinical trials coming soon for lymphoma patients:

  •  High risk relapsed FL at Royal Brisbane & Women’s Hospital and Royal Prince Alfred Hospital
  •  Relapsed (within 12 months) DLBCL at Peter MacCallum Cancer Centre, St Vincent’s Hospital Sydney and Fiona Stanley in Perth

Commercial access (self-funding) but currently not available :

  •   Royal Prince Alfred Hospital, Sydney
  •   Royal Children’s Hospital, Melbourne
  •  Peter MacCallum Cancer Centre, Melbourne

 

Image credit: https://www.novartis.com/news/media-library/car-t-cell-therapy-infographic