Earlier access to subsidised CAR T-cell therapy for lymphoma
18 December 2024
More patients with aggressive blood cancers can now access subsidised CAR T-cell therapy thanks to a change to eligibility criteria nationally, and Peter Mac patients are among the first to benefit.
Previously, patients with large B-cell lymphomas (LBCL) had to endure their cancer relapsing, or not responding to two separate treatment types before they became eligible for subsidised (at no cost to patients) CAR T-cell therapy.
Under a new agreement signed this month by the Australian Government and Gilead Sciences, Gilead’s CAR T-cell therapy product Yescarta can be provided via subsidy to LBCL patients after only one relapse or treatment non-response.
Professor Simon Harrison, Director of the Centre of Excellence for Cellular Immunotherapy, said the first patients have commenced treatment this week at Peter Mac under the updated eligibility criteria.
“We are delighted to see this expanded access to CAR T-cell therapy that in effect brings forward the window in which we can offer this potentially life-saving treatment to patients with aggressive B-cell lymphomas,” Professor Harrison says.
“We thank the Victorian Government for working so swiftly to ensure arrangements are in place and that Peter Mac can commence offering this CAR T-cell therapy to these newly eligible patients.”
In Australia about two-thirds of LBCL patients whose cancer does not respond to initial treatment or who ultimately relapse, do so within 12 months.
As Lead of the Aggressive Lymphoma Disease Group within Clinical Haematology at the Peter Mac and Royal Melbourne Hospital, Professor Michael Dickinson cares for many patients who may benefit from this change.
"CAR T-cell therapy offers a potential cure, but it is resource intensive treatment that involves collecting and re-engineering the patient’s own T-cells before infusing them back to combat their cancer,” Professor Dickinson says.
“The eligibility changes will both allow us to administer CAR T-cell therapy earlier to LBCL patients and eliminates cost as a barrier for these patients.
“This news will be welcomed by many Australians living with LBCL and their haematologists, particularly in circumstances where first-line treatment has not been successful.”
Professor Dickinson was also Australian lead and Peter Mac was a major recruitment site, and the only site in Australia, for the ZUMA-7 pivotal Phase III trial which provided the evidence underpinning this approval of Yescarta as a second-line treatment for LBCL.
Recently updated data from the ZUMA-7 clinical trial confirmed Yescarta continues to show a significant improvement in overall survival, compared to standard of care, at median follow-up of 47.2 months.
Under the eligibility changes, adults with CD19 positive LBCL whose disease is relapsed, or refractory, no more than 12 months after first-line chemoimmunotherapy, and meet additional eligibility criteria, will now have reimbursed access to Yescarta as a second-line therapy.
Discussions are also underway and independent agreements must be struck in each state before these Yescarta eligibility criteria in LBCL can be reflected universally in clinical practise in Australia.
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About Peter Mac
Peter MacCallum Cancer Centre is a world leading cancer research, education and treatment centre and Australia’s only public health service dedicated to caring for people affected by cancer.