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The first personalised immunotherapy treatment will now be routinely available for NHS patients with an aggressive form of blood cancer following new guidance from the National Institute for Care Excellence (NICE).
The treatment was previously accessible through the Cancer Drugs Found, but will now be available to hundreds of NHS patients with elapsed or refractory diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL) who have had two or more lines of systemic therapy.
DLBCL is an aggressive form of blood cancer which progresses quickly and is the most common type of high-grade non-Hodgkin lymphoma (NHL). It can develop at any age, but most people diagnosed with DLBCL are 65 or over.
More than 5,000 people are diagnosed with DLBCL each year in England
Axicabtagene ciloleucel (Yescarta, Kite) is a CAR-T therapy for adults that is administered as one-off intravenous infusion. The therapy takes a patient’s own immune cells and modifies them so that they attach to and kill cancer cells.
Around 5,500 people are diagnosed with DLBCL each year in England, however, until now, there was no standard treatment for relapsed or refractory DLBCL or PMBCL after two or more systemic therapies.
NICE says the new recommendations “shows the benefits of NHS England’s approach to entering promising treatments into the CDF.
Helen Knight, director of medicines evaluation, at NICE, said: “I am delighted that we have been able to recommend this pioneering treatment for people. The evidence from its use in the CDF and clinical trials shows it can offer an effective treatment, helping people live longer and with a better quality of life.
“This news illustrates how NICE is determined to get the best care to patients fast, while ensuring value for money for the taxpayer.”
Blood cancer patients on axicabtagene ciloleucel live longer than those on chemotherapy
The recommendation comes following new evidence which shows that people on axicabtagene ciloleucel live longer than people having chemotherapy and have longer before their condition gets worse.
Data from 318 people who took part in a clinical trial between December 2018 and October 2021 shows that people taking axicabtagene ciloleucel had a median overall survival of 28.5 months and 45% were alive after three years.
This compares to just 6.4 months for those who were on best supportive care – salvage chemotherapy.
NHS England’s Director of Specialised Commissioning and interim Commercial Medicines Director, John Stewart said: “This advanced therapy has been commissioned through the Cancer Drugs Fund since 2018, allowing evidence to be collected that confirms its benefits for patients facing this aggressive form of lymphoma and now enables the NHS to provide routine access at a fair price for taxpayers.”