Nottingham University Hospitals NHS Trust (NUH) is due to administer an innovative new treatment for blood cancers to the first patient at City Hospital on Monday 22 January.
This new therapy offers new hope to adult patients living with these conditions and NUH is the first centre in the East Midlands to provide this revolutionary treatment.
NHS England has commissioned NUH to deliver chimeric antigen receptor T-cell therapy (CAR T-cell therapy) at Nottingham City Hospital, where it will provide this highly specialist service for most of the region, including for patients from Nottinghamshire, Lincolnshire and Derbyshire.
CAR T-cell therapy is a new personalised treatment, which uses the patient’s own genetically modified immune system cells (T-cells) to target and kill cancer cells.
“CAR T-cell represent a significant breakthrough in the field of cancer immunotherapy and administering this therapy for the first time to our patients is a landmark achievement,” said Dr Nicolas Martinez-Calle, CAR T-Cell Clinical Lead and a consultant haematologist at NUH.
“This is a major breakthrough for our patients, as the launch of our service at City Hospital means they can access a state-of-the art treatment without the need to travel to other centres in different cities, as was the case previously.”
Dr Mark Bishton, Divisional Research & Innovation Co-Lead for Cancer and Associated Specialties at NUH, said: “The introduction of CAR T-Cell therapy at Nottingham University Hospitals is a great breakthrough for our patients and continues our pioneering work in this area of medicine, including our previous introduction of stem cell therapy and novel anti-cancer therapies at City Hospital.
“Previously, these patients’ outcomes were often very poor, but the CAR T-Cell therapy provides a step change in care improvement.”
“Scientific data from the approved CAR T indications is very promising, showing unprecedented rates of complete – and sustained – remission in patients who otherwise would have no other treatment alternative. And in the case of Diffuse Large B-cell lymphoma, it provides an overall survival advantage compared to current therapies.”
The majority of patients who will receive CAR T-cell therapy at NUH are people with refractory aggressive B-Cell lymphoma, where this has not responded to first line treatment.
NHS England has also commissioned NUH to deliver the service for other indications typically after failing one or more lines of treatment, which are Mantle cell lymphoma (Brexu-cel), Transformed follicular lymphoma (Axi-cel), Primary mediastinal large B-cell lymphoma (Axi-cel) and acute lymphoblastic leukaemia (Tisa-cel and Brexu-cel).
The first step in this new therapy involves drawing a patient’s T-cells from their blood in a process known as leukapheresis.
These cells are sent to a secure manufacturing facility. Here, the T-cells are given new DNA instructions to act as CAR T-cells with the ability to target lymphoma and similar disease directly and with high efficacy. The newly re-engineered CAR T-cells then multiply and grow in the laboratory.
Once there are enough CAR T-cells, these cells are frozen and then sent to back to the hospital where they are reinfused into the patient following priming chemotherapy.
Patients will then spend around 10 days recovering on Fletcher Ward at City Hospital and being closely monitored during this period, before going home.
NUH has invested in staff and new equipment to deliver this new service. The treatment will be delivered by the lymphoma and acute leukaemia teams from the Haematology department, within the existing bone marrow transplant service at Nottingham City Hospital.
Catherine Birch will be working as the CART clinical nurse specialist alongside other clinicians, and the wider team includes colleagues from critical care and neurology department who will help manage the risks associated with this highly specialist treatment.
The development of CAR T services for patients will also enable NUH to develop more new treatments and innovations in cancer care through the NIHR Nottingham Clinical Research Facility. This is based at NUH and specialises in early phase research into new drugs and medical technology.
Patients who are interested in accessing the new treatment should discuss the treatment or their suitability with their clinician in the first instance.