Hi Anne,
I understand that the provider has withdrawn their proposal due to manufacturing issues of Car-T in UK. As you have said, the reasons are more complex than the one major reason. I would like to know what happens next to making Car-T available as treatment protocol in the UK. I have not looked at Car-T in US in detail as I am aware that it has been available in US for some time. The EU case is more interesting as it is more recent and its treatment ‘lines’ are similar to UK. Car-T has become available to EU patients recently, in February 2024 for people who who have received at least 1 prior therapy.
It was approved on the basis of a clinical trial which compared a medical specialist’s choice of either pomalidomide, bortezomib and dexamethasone (PVd) or daratumumab, pomalidomide and dexamethasone (DPd) until disease progression. It was found that people who received Car-T had a stronger and deeper remission compared to people in the standard treatment group.
Here is the link for Cartitude 4 trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2303379
Regarding the side effects, Car-T has fewer side effects on immunosuppression than standard medications. Its main side effects are during administration of the treatment.
I would like to know if Myeloma UK is undertaking some actions on the government level to make Car-T available in UK. There is clearly a gap for a treatment with less immunosuppressive side effects that is already on the market. For people who are on lenalidomide maintenance like myself, neutropenia side effect can lead to breaks in the treatment and premature death. Most standard medications have this side effect, so Car-t can in principle give people a form of respite from those traditional side effects while keeping myeloma supressed.
