b cell lymphoma staging | CAR - T CELLS: THE TREATMENT OF CANCERS OF THE BLOOD ON THE CUSP OF A MAJOR REVOLUTION

CAR - T CELLS: THE TREATMENT OF CANCERS OF THE BLOOD ON THE CUSP OF A MAJOR REVOLUTION



The market in the United States of the two first gene therapies based on the technology of CAR - T cells use the patient's own genetically modified immune cells to destroy the tumor cells, constitute a possible revolution in the treatment of cancers of the blood.
"The market of this type of treatment is a major breakthrough for patients. The results observed on the complete response rate are new and very encouraging. "We are in a paradigm shift to treat cancers of the blood and so probably on the cusp of a major revolution", believes Professor Gilles rooms, Chief of service in Clinical Hematology at the Hospices civilians Lyon (hospital Lyon-South Central) and President of the LYSA.

LYSA (Lymphoma Study Association) is a cooperative group with more than 500 doctors, clinicians and researchers of 120 centres in Europe. He works for clinical research against Lymphoma, first blood cancer and the 6th most common cancer.

The American Agency of the drug (FDA) recently approved in the last three months implementing the US market two drugs based on the technology of CAR - T cells. Kymriah (Novartis), approved in August for a form of very aggressive leukemia in children and young adults, showed a remission in 83% of patients. A request for extension of indication was filed for the third line treatment of diffuse B Lymphoma large cell (DLBCL) recurrent or refractory in patients unable to undergo transplantation of Autologous stem cells. The second drug, approved in October, is the Yescarta (Kite/Gilead) for treatment also the B-cell lymphoma diffuse large cell, an aggressive non-Hodgkin lymphoma. They cater to patients in failure of conventional treatments.

"Today, for the B-cell lymphoma large cell, most common lymphomas, there is no standard treatment when the patient is in his second relapse. The immunochimiotherapie gives poor results, with less than 10% of remission, while the Yescarta allows for a 50% remission rate. "It's so pretty remarkable", points out the Dr. Richard Delarue, a hematologist at the hospital Necker (AP - HP) in Paris and member of the Board of Directors of the LYSA.

Available for french patients as soon as 2018?
Applications for marketing authorisation on the European market of these therapies are underway. In France, with more than 4,000 new cases of lymphoma large cell B newly diagnosed each year, and although the majority of them will heal with the first treatment, we can estimate several hundred patients who might benefit from this type of treatment, especially if we can better predict and/or control the side effects of the CAR - T.

"We hope that the firms and national health authorities in different countries can quickly enable patients to benefit from these innovative treatments. For patients french, we hope that through clinical trials that will be implemented in France, temporary authorizations (ATU) devices, patients will benefit from access to these treatments as soon as 2018" States Pr rooms.

Is also the issue of reimbursement and supported by national health authorities, because if a single injection is sufficient, it is charged however currently in the United States between 373,000 and 475,000 dollars (only when the) treatment was successful).

"We need these costs in relation to those of other therapies recently approved for various cancers and the results obtained. Our solidarity-based health care system is put to the test with the cost of new drugs but it is a major innovation, of a technological breakdown, and we must consider the possibility that seems open to heal with the CAR - T some patients in whom other treatments had failed", points out the Pr rooms.

New challenges for the Hematologists
Many studies are still going to be necessary because, at the moment, these treatments are not effective in all patients and their side effects can be severe, even deadly.

"More recoil will better understand why and what is the impact on the survival of these patients. Can we cure some? If Yes, which? What will be the role of these new treatments in the therapeutic arsenal and their potential effectiveness in other types of lymphoma? ", asks Dr. Richard Delarue, for whom these new treatments also represent a challenge for the Hematologists. "He'll f.