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Patients with an aggressive type of blood cancer are set to benefit from a ‘potentially curative’ new treatment option on the NHS.
Glofitamab (Columvi) has been approved by the MHRA and recommended by NICE for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
The treatment, which is administered intravenously, will be available within a matter of weeks to patients who have had two or more cancer treatments that have not been fully effective.
What is DLBCL and how is it usually treated?
DLBCL is a type of non-Hodgkin lymphoma (NHL); a cancer of the lymphatic system.
Around 5,500 people are diagnosed with DLBCL in England each year, which mainly affects men aged 65 and over, with the most common symptom being painless swellings of the glands.
DLBCL is usually treated with a number of different chemotherapy drugs, a steroid and a targeted immunotherapy drug. There are different combinations, but one of the main combinations is R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisolone).
How does glofitamab work?
Glofitamab is given as an intravenous infusion, with the first infusion typically given over four hours. Patients must be monitored during and after the infusion for 24 hours to watch for signs of cytokine release syndrome.
If the patient does not have any cytokine release syndrome symptoms after three doses, the following infusion may be given over two hours.
The treatment uses bispecific antibodies which use the patient’s own white blood cells to attack and kill the lymphoma.
“The antibody has two arms,” explains Dr Wendy Osborne, an NHS consultant haematologist specialising in lymphoma. “One arm attaches to the cancer cell and the other to the patient’s own white blood cell, a T-cell.
“By bringing these cells together, the patient’s own immune system is activated and kills the cancer cell and so chemotherapy is not required. Patients don’t have the side effects of chemotherapy and often feel well on this outpatient-based treatment.”
Glofitamab will be available to more than 700 patients with DLBCL and will be offered from a variety of cancer treatment sites across the country.
How effective is glofitamab?
Clinical trial evidence shows that glofitamab is clinically and cost effective, and in one trial, 38 out of 108 patients with relapsed or refractory DLBCL reached complete remission with no signs or symptoms of cancer.
The drug has also been shown to extend healthy life years, with some trial participants living longer with a better quality of life.
John Sharp, 68, from Northumberland is now in remission and able to walk again following treatment with glofitamab. Before this treatment, he was reliant on a wheelchair.
John had was diagnosed with low grade lymphoma in 2001, which transformed to high grade lymphoma in 2021. He had chemotherapy and CAR-T treatment, but his cancer returned.
Then, earlier this year, John started treatment with glofitamab via a compassionate access scheme. After just three cycles, John was in complete remission and able to walk again.
He said: “I can’t believe I’m in remission after so many previous treatments – I can go out now with friends and family, I previously needed a wheelchair and now I can walk.
“I was as weak as water, and I feel so different now: it’s like chalk and cheese – my family and I are really grateful for this new drug and my treatment at the Freeman Hospital under the care of Doctor Osborne.”
An alternative for some blood cancer patients eligible for CAR-T
NHS England’s Cancer Drug’s Fund Lead, Professor Peter Clark, said: “The approval of this drug is great news for people living with an advanced and aggressive form of blood cancer, who are set to benefit from this new treatment.
“Not only does it provide a potentially life-saving option for patients who may have not responded to CAR-T therapy, it is also an alternative for some CAR-T eligible patients who choose instead to have glofitamab closer to home.
“This is the latest in a long list of cutting-edge drugs available on the NHS to help people with cancer live a longer and better-quality life.”