Specialists and patients especially noted this Wednesday, on the eve of the celebration World Lymphoma Daythe importance of advanced CAR-T therapy in the fight against this disease.

They emphasize that advanced CAR-T therapy represents a breakthrough because they provide therapeutic options in pathologies and situations in which other treatments are not yet sufficient, as in the case of some aggressive forms of lymphoma.

Effective therapies are now available, such as tisagenleucel, therapy with CAR-T cells approved for treatment of children and young adults with lymphoblastic leukemia acute B-cell and in adult patients with follicular lymphoma or diffuse large B-cell lymphoma after two or more lines of treatment; or also axicabtagene ciloleucel for the treatment of adults with follicular lymphoma or with some types of refractory large B-cell non-Hodgkin’s lymphoma, which has already shown a 50% survival rate after five years, while before that the rate was only six months, is considered a very important milestone during the last American Congress of Hematology.

Guillermo Rodríguez Garcia, a hematologist at the Virgen del Rocío Hospital in Seville, explained medical letter that some cutting-edge therapies, such as brexucabtagen autoleucel — for treating adults with mantle cell lymphoma that has recurred or has not improved with other cancers — have been shown to be effective in this lymphoma, and there is “hope” for patients who, in some cases they have no other alternative, since the disease is still incurable. “The absence of this drug in Spain is a significant deterioration in the lives of these people.”

In early June, the Ministry of Health designated 14 new hospital centers, one exclusively for pediatrics, that are allowed to administer CAR-T drugs, as part of the SNA’s network of advanced treatments.

“Spain doubles its healthcare capacity to address serious public health concerns with these cutting-edge therapies,” Health Minister Carolina Darias said a few weeks ago, who also reaffirmed the government’s commitment to “advanced medicine in leading hospitals to fight cancer with treatments that will improve both efficiency and safety”.

However, the increase in the number of qualified centers has not led to the inclusion of new cellular therapies in the SNA portfolio, which, nevertheless, are approved at the European level.

According to WAIT’s annual report, the average time from receipt of a new drug in Europe to when it becomes available for use in Spain is 517 days, more than 17 months of delay. For cancer, the wait is 469 days (in some cases it can be up to 1,000 days before approval is received), up 74 days from 2018.

The percentage of availability of anti-cancer drugs approved in Europe between 2017 and 2020 in Spain is 61% (25 out of 41 anti-cancer drugs approved during this period are available), which means that Spain has the lowest rate compared to your environment. since this availability reaches 100% in Germany; 90% in Italy; 85% in England and 80% in France.

Some sectors warn that this delay in approval, along with the existing system for funding new drugs, leaves treatments for some cancers in limbo. Among them are therapies aimed at certain multiple myelomas or lymphomas, the prognosis of which is very serious.

They point out that other drugs intended for the treatment of extremely serious hematological pathologies, such as multiple myeloma, an incurable blood cancer whose patients suffer constant relapses and who decry delays in access to life-saving drugs, are in a similar situation. Although there are innovative medicines approved by the EU, such as idekabtagen vikleusel, their SNA funding has not yet been approved in Spain, making it difficult for them to reach patients.

Patients, through the Spanish Association of People Affected by Lymphoma, Myeloma and Leukemia (AEAL), claim to have improved their quality of life and survival, which is reflected in their “Take it into account” campaign, which in addition aims to remind the population, that the importance of warning signs hiding blood cancer should not be underestimated.

advanced treatments

Chimeric antigen receptor (CAR-T) cell therapy is a way to get immune cells called T cells (a type of white blood cell) to fight cancer by modifying them in the lab so they can find and destroy cancer cells.

In Spain, the medical committee assesses whether a patient with completed blood cancer is healthy or not to receive CAR-T treatment. If their inclusion is approved, the patient is admitted to one of the 23 Spanish centers authorized to provide this type of therapy in adults (there is only one center authorized for therapy in children).

One day in the hospital T cells are removed from the patient’s blood for subsequent shipment in frozen form to a center in Europe where genetic reprogramming of cells is carried out. These modified cells are cryogenized and sent back to Spain, where they are injected back into the patient, after which the person is monitored in the intensive care unit under the supervision of various specialists and departments of the hospital for exhaustive monitoring. therapy.

Once this stage is over, the patient will be able to return home and the circulating T cells in his body will disappear. slow detection and destruction of malignant cells. In the following months, periodic tumor evaluation tests will show response to CAR-T treatment.