Now, doctors at King’s College London are claiming that they may be able to help cure terminal blood cancer — lymphoma — patients.
A revolutionary new drug
The pioneering new treatment is called (chimeric antigen receptor) CAR-T therapy. Doctors are likening it to a “living drug.” (1) What makes it so powerful is the fact that it’s specially made using patients’ own cells.
Although it is early to make any absolute claims and because more data is needed, a study in The New England Journal of Medicine found that, in a trial, CAR-T therapy eliminated all signs of lymphoma in 40% of terminal patients just 15 months after treatment. (2)
“It is a very exciting new development and it gives new hope to a lot of our patients. It’s amazing to be able to see these people, who you may have not been able to give any hope to, actually achieving remission,” consultant hematologist at King’s College, Victoria Potter, told BBC. “And that is a situation we have never see before and it’s an incredibly impressive change in the treatment paradigm.”
How does CAR-T therapy work?
Considered an immunotherapy, CAR T-cell therapy is a type of cellular therapy. In it, doctors help attack the patient’s cancer with his or her own immune system cells.
According to the Dana-Farber Cancer Institute, CAR-T cells are made by extracting T cells — white blood cells that help protect the body from disease — from the patient’s blood. From there, the cells are modified to intensify the immune system’s natural response to cancer. Once this is done, those modified CAR T-cells are re-injected into the patient and, as a result, seek out and destroy cancerous cells. (3)
This two-and-a-half-minute video gives a perfect visual explanation for how this is done:
Meet 62-year-old Mike Simpson
In 2015, Simpson returned from a holiday with a neck that was stiff and swollen. Doctors diagnosed him with large B-cell lymphoma.
He underwent two bouts of chemotherapy which helped — but not enough. Three years later, doctors told Simpson he had two years to live, with no promise that the quality of life would be high.
In partnership with pharmaceutical company Gilead Sciences, the National Health Service (NHS) England offered Simpson a treatment that would change his life — CAR-T therapy.
By February 2019, Simpson began the “living drug” treatment and so far, follow-up scans suggest that it’s working!
“I feel the treatment really is being effective, that we’ve got the cancer pretty much on the run,” said Simpson. (1) “Obviously I’m really happy about that and optimistic for the future and glad that I committed to the treatment.”
Symptoms of CAR-T therapy
While the symptoms of this treatment may vary from patient to patient, some of what Simpson experienced includes:
- Short-term neurotoxicity
- Difficulty speaking
- Loss of consciousness
In Simpson’s own words: “It might be a magic bullet, but it hurts.”
Blood cancers present less collateral damage
CAR-T therapy has been shown to be most effective for blood cancers such as lymphoma and leukemia. The modified cancer-fighting T cells target proteins that protrude from the surface of cancerous cells. However, healthy cells also have this protein attached. In CAR-T therapy, the cells will attack both cancerous and healthy cells.
“That’s OK if it’s a blood cancer you’re dealing with but if you’ve got lung cancer,” The Sun author Miranda Larbi writes, “you can’t kill bits of the lung without killing/seriously impacting the health of the patient.” (4)
It comes with a cost
Unfortunately yet unsurprisingly, the official list price for the CAR-T therapy — called Yescarta — is over the equivalent of $350,000. As BBC author James Gallagher writes, this is likely due to the fact that it’s truly personalized medicine.
Regardless, NHS England’s chief executive Simon Stevens believes that “CAR-T shows huge promise and it is fantastic to see that patients in the NHS are among the first in the world to benefits… The start of this treatment marks the beginning of a new era of personalized medicine.” (1)
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