The NHS is providing CAR-T therapies for children and young people with B cell acute lymphoblastic leukaemia.

NICE also recommended CAR-T therapy for adults with diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma in England.

CAR-T – chimeric antigen receptor T-cell – therapy is specifically developed for each individual patient and involves reprogramming the patient’s own immune system cells which are then used to target their cancer. It is a highly complex and potentially risky treatment but it has been shown in trials to cure some patients, even those with quite advanced cancers and where other available treatments have failed.

The interim service specifications for CAR-T therapy can be found at the following links:

• Axicabtagene Ciloleucel Chimeric Antigen Receptor T Cell (CAR T) Therapy for the treatment of adult patients with relapsed or refractory large B-cell lymphoma
• Tisagenlecleucel Chimeric Antigen Receptor T Cell (CAR T) Therapy for ALL and DLBCL

What is Chimeric Antigen Receptors Cell Therapy (CAR-T)?

CAR-T is a highly complex and innovative new treatment. CAR-T is a type of immunotherapy which involves collecting and using the patients’ own immune cells to treat their condition.

Can you explain what the treatment involves?

The treatment involves several steps over a number of weeks.

First the patient’s blood is taken and is sent off to the manufacturer’s laboratory. Here the patient’s blood is ‘trained’ to fight the cancer cells.

The CAR-T blood is then transported back to the hospital and the patient is administered with the CAR-T to treat their condition.

What conditions can CAR-T Cell Therapy work for?

Currently, NICE has approved CAR-T use in the NHS where all other treatment options have been unsuccessful for relapsed or refractory B-cell acute lymphoblastic leukaemia (ALL) in people up to the age of 25 years.

A second one has been approved for relapsed or refractory diffuse large B-cell lymphoma (DLBCL)  after 2 or more systemic therapies.

Who is eligible for the treatment?

The decision on which patients are eligible will be decided by a panel of expert clinicians following a referral from a specialist doctor.

Please speak to your consultant about whether CAR-T is the right treatment and, if so, they can advise you on the referral route.

The treatment will be available to patients across the country.

Where is the treatment available and which centres will be providing the treatment?

NHS England has been working with The Joint Accreditation Committee ISCT-Europe and EBMT (JACIE) and the life sciences companies to get centres up and running.

The following centres will be able to provide CAR-T for acute lymphoblastic leukaemia for children and young people up to the age of 25:

1. Barts Health NHS Trust
2. Cambridge University Hospitals NHS Foundation
3. Great Ormond Street Hospital
4. Imperial College Healthcare NHS Trust
5. King’s College Hospital
6. Leeds Teaching Hospitals NHS Trust
7. Manchester University Hospital NHS Trust
8. Newcastle University Hospitals NHS Foundation Trust
9. Nottingham University Hospitals NHS Trust
10. Oxford University Hospitals NHS Trust
11. Royal Marsden Hospital NHS Foundation Trust
12. Sheffield Teaching Hospital NHS Foundation Trust
13. The Christie NHS Foundation Trust
14. University College London Hospital
15. University Hospital Southampton NHS Foundation Trust
16. University Hospitals Birmingham NHS Foundation Trust
17. University Hospitals Bristol NHS Trust

The following centres will be able to provide CAR-T for adults with large B-cell lymphoma and mantle cell lymphoma, and adults aged 26 and over with acute lymphoblastic leukaemia:

1. Barts Health NHS Trust
2. Cambridge University Hospitals NHS Foundation Trust
3. Imperial College Healthcare NHS Trust
4. King’s College Hospital
5. Leeds Teaching Hospitals NHS Trust
6. Manchester University Hospital NHS Trust
7. Newcastle University Hospitals NHS Foundation Trust
8. Nottingham University Hospitals NHS Trust
9. Oxford University Hospitals NHS Trust
10. Royal Marsden Hospital NHS Foundation Trust
11. Sheffield Teaching Hospital NHS Foundation Trust
12. The Christie NHS Foundation Trust
13. University College London Hospital
14. University Hospital Southampton NHS Foundation Trust
15. University Hospitals Birmingham NHS Foundation Trust
16. University Hospitals Bristol NHS Trust