CAR T cell immunotherapy for lymphoma rejected in Scotland
Patients living with an aggressive form of lymphoma in Scotland will not get routine access to a new immunotherapy treatment after it was rejected for use on the NHS.
The cancer immunotherapy has been refused funding by the Scottish Medicines Consortium (SMC) due to uncertainty around the long-term benefits of the treatment.
Kymriah (tisagenlecleucel) was being reviewed as a treatment for adult patients with an aggressive type of non-Hodgkin lymphoma whose cancer has either come back after, or not responded to, 2 or more different types of treatment.
It forms part of a new line of immune-boosting CAR T cell therapy treatments, which take a patient’s own immune cells and modify them in a lab before reintroducing them into the body.
Gregor McNie, Cancer Research UK’s head of external relations in Scotland, called the rejection “disappointing” for lymphoma patients in Scotland.
He said: “If approved, Kymriah would have provided a new treatment option for patients with this aggressive type of blood cancer who might have few other options available to them.
The same CAR T cell therapy was approved in February 2019 for the same patients on the Cancer Drugs Fund in England, following an initial rejection.
The clinical trial
Half of the 93 patients saw their disease respond to Kymriah, with the disease completely disappearing in 4 in 10 patients 3 months after treatment in the latest clinical trial.
Patients haven’t been followed up for long enough yet to fully understand how long responses to the treatment last. The trial found the immunotherapy caused severe side effects, including neurological problems and serious infections.
‘Uncertainties’ around long-term benefits
The SMC didn’t recommend Kymriah because of “uncertainties in the company’s evidence around its long-term benefits”.
This decision comes after the National Institute for Health and Care Excellence (NICE) approved Kymriah for the same group of patients in England in February 2019. NICE had initially said no to the treatment due to uncertainty about long-term benefits.
Kymriah was also approved for use in Scotland for children and young adults with a certain form of leukaemia in February 2019.
McNie said that he hopes the SMC and the drug company can work together to make Kymriah routinely available to more patients in Scotland in the future.
Patients in Scotland will still be able to apply for funding to receive Kymriah on an individual basis, if their doctor feels they would benefit from having the treatment.