King’s College Hospital is the first in the UK to use a newly approved stem cell therapy treatment for patients with lymphoma.
Chimeric antigen receptor T-cell therapy, known as CAR-T therapy, is a complex, personalised treatment that involves harvesting T cells – immune cells that recognise and kill viruses – from the patient and reprogramming them to recognise and kill cancer cells.
The pioneering treatment is currently being used on selected adult patients at King’s whose lymphoma has recurred.
Lymphoma is a cancer that starts in the immune system; in cells in the lymph nodes, spleen, thymus, bone marrow and other areas.
Research shows the treatment is effective in around 40-50 per cent of cases, including patients who have not responded well to chemotherapy.
However, the treatment also has some unpleasant, short-term side effects.
While being treated with CAR-T, patients are also screened for anxiety and depression and given mental health support to cope with the side effects of treatments.
This joined-up approach to mental and physical health is unique in the UK, and thanks to a partnership between King’s Guy’s and the Maudsley.
One of the first CAR-T patients is Mike Simpson, aged 62, from Durham.
The married father-of-two was diagnosed with stage 4a Diffuse Large B-Cell Lymphoma, a form of blood cancer, in 2015.
After receiving chemotherapy and radiotherapy at his local hospital, and going into remission, he then relapsed ten months later.
After going into remission for a second time, his cancer returned.
He said: “In October 2018, I began experiencing back pain, stomach discomfort and severe vomiting so I went for more tests and was given the news the cancer was back.
“Dr Wendy Osborne and colleagues at the Northern Centre For Cancer Care (NCCC), Freeman Hospital Newcastle, explained CAR T therapy, which looked very promising so when I was given the opportunity to have the therapy at King’s I jumped at it, and I am very grateful the team at NCCC put me forward.”
Mike’s cells were harvested in early January 2019 and sent to the USA to be modified before being transfused in February.
“The team at King’s explained all about the treatment and possible side effects,” he said.
“Despite this, it still came as a big shock to me and my family when I became unwell a few days after the infusion.
“It was no walk in the park. I spent almost a week in intensive care and when I was well enough to be moved back to the ward I had to re-learn basic tasks such as climbing stairs.
“I was fortunate to have the support of my wife and children, who had to watch me go through the changes hoping all the time they would be temporary.”
He is now back at home and hopes to return to work.
“I’m incredibly grateful for being given the opportunity to have this therapy as I know it’s a costly, one-time treatment.
“I describe it as my L’Oreal treatment… because I’m worth it,” he laughed.
Simon Stevens, chief executive of NHS England Improvement said, “CAR-T shows huge promise and it is fantastic to see that patients in the NHS are among the first in the world to benefit.
“The start of this treatment marks the beginning of a new era of personalised medicine, and forms part of the upgrade in cancer services which are set out in the NHS long term plan.”
Dr Victoria Potter, consultant haematologist and director of stem cell transplantation at King’s, said, “In cases such as Mike’s, CAR-T therapy is a last resort when other treatments have failed.
“Although it does not work for everyone, from what we have observed in clinical trials this type of personalised medicine offers real hope for lymphoma patients who otherwise would have limited options.
“We are very hopeful this treatment will be a game-changer for our patients.”