Slovak National Cancer Institute introduces CAR T-cell therapy [Advocacy Lab Content]

3 months ago 30

Slovakia’s National Cancer Institute (NOÚ) is offering new hope to patients with otherwise incurable diagnoses, with the launch of innovative CAR T-cell therapy for lymphoma and leukaemia treatment.

The National Cancer Institute is the first in Slovakia to introduce innovative CAR T-cell therapy (Chimeric Antigen Receptor T-cell) for patients with lymphoma and leukaemia.

CAR-T therapy, a revolutionary immunotherapy, uses genetically modified white blood cells to fight cancer cells. The patients provide their own type of white blood cells (T-cells) for the drug, which are genetically engineered, reprogrammed, and multiplied by a company in a foreign laboratory. Then the NOÚ injects them back into the body, where they can recognise and attack the cancer cells.

The Oncohematology department at the NOÚ became Slovakia’s first certified centre for CAR-T cell therapy. Twenty-three patients have already undergone therapy with genetically altered cells at the Institute.

“This treatment can have a major impact on the prognosis of some incurable patients,” said the head of the Oncohematology department, Dr. Andrej Vranovský.

Chair of the Oncohematology department, Dr Ľuboš Drgoňa, added: “We believe that this treatment can be another pillar of oncological treatment for other cancers as well.”

Success rate

The therapy is more effective than previously available treatment methods in patients with unfavourable prognoses. According to the Institute, out of ten seriously ill patients with no hope of cure, 3 to 4 should achieve remission of their illness.

Patients with five specific lymphoma diagnoses can receive CAR-T cell therapy. Treatment is given to patients whose disease has returned within a short time or is resistant to conventional treatments such as chemotherapy.

“At the National Cancer Institute, we are constantly trying to push the boundaries of what is possible in the fight against cancer. For us, CAR-T therapy is not only a symbol of medical progress, but above all a promise for patients who find themselves at the end of standard treatment options,” the director of the NOÚ, Tomáš Alscher, said at a press conference.

Side-effects

The therapy also comes with side effects. The most feared are cytokine release syndrome (CRS) and immune neurotoxicity syndrome (ICANS). “Although we can manage side effects, they still remain a major risk of this treatment,” explains Dr. Vranovský.

“One of the challenges for the future will be to modify the therapy so that it has lower side effects, lower cost, and greater availability. And this is already gradually happening,” added Dr. Drgoňa.

Since the EMA’s approval, the product information has advised that patients treated with these products may develop secondary cancers. Thus, patients need life-long monitoring for metastatic cancers.

Improved availability

The EMA currently has six authorised CAR-T therapies, two of which are available in Slovakia.

The therapy, priced at approximately €300,000 to €350,000, was previously an out-of-pocket expense for patients. Until this year, health insurance companies in Slovakia did not reimburse CAR-T treatments.

According to the National Institute for Value and Technologies in Healthcare, the medicines Yescarta and Kymriah fulfil the cost-effectiveness criteria and have been recommended for categorisation.

However, as this is a costly treatment, patients must receive approval from a committee to have the medication reimbursed by their health insurance company.

“Our efforts do not stop at individual therapies. We want to create comprehensive treatment programmes that are tailored to the needs of our patients while utilising the latest findings from oncology science and research. We recognise that every patient is unique, and therefore, our work is constantly focused on individualising and personalising treatment,” remarked Alscher.

[By Filip Áč, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]