01 February 2019

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

Adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) will be able to access another revolutionary chimeric antigen receptor T-Cell (CAR T-cell) therapy through the Cancer Drugs Fund.

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

Lymphomas are cancers of the lymphatic system which is part of the immune system. 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.

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.”

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.

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.

Lymphoma Action Chief Executive, Ropinder Gill, said: “We’re very pleased that this ground-breaking CAR T-cell therapy will now be available on the NHS for some people with diffuse large B-cell lymphoma.  This is really good news for people affected by this type of lymphoma who, until now, have faced limited treatment options. The news offers patients and their families faced with a poor prognosis a more hopeful outlook.”

John Stewart, Director of Specialised Commissioning at NHS England said: “The NHS has agreed another deal with the manufacturer Novartis which means that from next week more patients will benefit from this game changing treatment at even more hospitals throughout the country.

“Providing the latest cutting edge treatments for patients through competitive drug deals and offering more personalised medicines like CAR T-cell therapy are just two of the ways that the NHS Long Term Plan will transform cancer care across the country.”

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."

This final draft guidance follows two recent CAR T-cell therapy recommendations, axicabtagene ciloleucel for adults with DLBCL and tisagenlecleucel for young people with leukaemia.

Recommending another revolutionary CAR T-cell therapy for adults with lymphoma represents a step forward for personalised medicine

Meindert Boysen, Director of the Centre for Health Technology Evaluation at NICE

This is really good news for people affected by this type of lymphoma who, until now, have faced limited treatment options

Ropinder Gill, Lymphoma Action Chief Executive

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

Dr Alasdair Rankin, Director of Research and Patient Experience at the blood cancer charity Bloodwise