30 January 2023

Hundreds of people with an aggressive form of lymphoma will be able to have the first personalised immunotherapy treatment for the condition after gaining the green light from NHS regulators.

The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending the CAR-T therapy Axicabtagene ciloleucel – also known as Yescarta – be made routinely available on the NHS for certain people with lymphoma.

The therapy will be made available to adults with relapsed 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.

Previously, it was available through the Cancer Drugs Fund (CDF) but this will change after the NICE independent appraisal committee considered new evidence. This included data from a clinical trial and from people having axicabtagene ciloleucel through CDF.

Findings suggested that people having axicabtagene ciloleucel live longer than those who have chemotherapy, and it takes a longer time for their condition to deteriorate.

In total, 318 people received treatment through the CDF between December 2018 and October 2021 in England. According to data collected for the CDF, median overall survival was 28.5 months and 45% were alive after three years.

The manufacturer estimates the median overall survival on best supportive care – salvage chemotherapy – is about 6.4 months. They estimate that just over 450 people in England will be eligible to receive axicabtagene ciloleucel under the new recommendation.

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.”

NHS England’s director of specialised commissioning and interim commercial medicines director John Stewart added: “Five years ago the NHS led the way in Europe by striking commercial deals for revolutionary CAR-T cancer treatment and today we have used our commercial capabilities to reach a deal that secures long-term patient access to this personalised therapy.

“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."


Source: NICE


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