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05 September 2019

UH Bristol providing ground-breaking and life-saving cancer treatment

Doctors at University Hospitals Bristol NHS Foundation Trust are among the first in the UK to offer a revolutionary and life-saving treatment to patients with certain types of cancer.

UH Bristol is one of six sites in the country providing CAR-T cell therapy, a newly developed and completely personalised way of treating types of lymphoma and leukaemia. CAR-T cell therapy is used when other methods of treatment such as chemotherapy have been unsuccessful and it has been shown in clinical trials to be successful at eradicating all signs of otherwise untreatable cancers in 40-50% of patients.

It involves taking white blood cells, known as T-cells, from the patient, reprogramming them into chimeric antigen receptor T-cells or 'CAR-T cells' and then infusing them back into the patient's bloodstream. Once infused, the genetically reprogrammed CAR-T cells recognise and attack cancer cells rather than bacteria and viruses that they would usually target.

Dr Rachel Protheroe,consultant haematologistand the clinical lead of CAR-T cell therapy at UH Bristol, said:

"CAR-T cells therapy is a completely personalised, ground-breaking treatment and a massive step forward in cancer treatment. We're extremely proud to be providing this life-changing treatment to patients. As medical professionals, our job is to care for and look after our patients as best as we can. CAR-T cell treatment is another way we can do this and it gives us and, more importantly, our patients the chance of cure in situations where previously, there wouldn't have been much more we could do."

Currently, UH Bristol is treating patients who have relapsed refractory acute lymphoblastic leukaemia (ALL) and large B cell lymphoma. In order to provide CAR-T, clinicians at the Trust have recruited a number of specialist staff, including consultants and nurses who work closely with other clinical and patient support teams in UH Bristol as well as with a number of key partners such as North Bristol NHS Trust, NHS Blood and Transplant and the pharmaceutical companies who carry out the cell reprogramming process.Rachel added:

"Setting up such a specialist new service such as CAR-T cells therapy is extremely complex. We are effectively setting up an entirely new hospital department, akin to a new transplant unit.The expertise we already had in our teams and the infrastructure we have in place at UH Bristol has been key to doing this and we're now extremely excited for what the future holds for CAR-T both at UH Bristol, and beyond."

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Nitya Raghava, 19, from Gloucestershire was the first patient to undergo CAR-T cell therapy at UH Bristol. She was diagnosed with acute lymphoblastic leukaemia in 2016 and relapsed in 2018.  She had undergone a number of different treatments, before receiving a bone marrow transplant.  She relapsed again within three months of this and was then considered for CAR-T cell therapy. Her cells were collected the day after UH Bristol became accredited as a CAR-T cell centre in December 2018 and she then received the CAR-T cells in February 2019.  She has been in remission since then. Speaking about her experience, Nitya said:

"When I relapsed after transplant, I felt incredibly lucky to still have the chance of a cure through CAR-T cells. Although it seemed daunting, I found it much easier to cope with than the stem cell transplant as I felt fairly well throughout and was able to leave hospital four weeks after I received the cells. Now, six months later, I am in remission and feel as close to normal as I have in years; I'm eating well, my hair's growing back, I'm able to go out and even intend to start my studies at university in September. I cannot thank the NHS, especially Dr Protheroe, Professor Marks and everyone on ward D703 in Bristol, enough for all they have done and are still doing for me, and for the new hope that my family and I have been given."

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In 2017, Denise Williams, 65, from Solihull, was diagnosed with non-hodgkins lymphoma. She underwent various types of chemotherapy treatment at her local hospital in Birmingham. Unfortunately this failed to eradicate the cancer and in April 2019 Denise was referred to the Bristol Haematology and Oncology Centre to undergo CAR-T. Since the treatment finished, scans have suggested that the lymphoma is in remission and Denise is now back at home starting her recovery. She said:

"After hearing I had been accepted onto the CAR-T programme I felt I had been thrown a lifeline. I was initially apprehensive at being away from home, but the care and attention I received from the medical staff at Bristol Haematology and Oncology Centre helped to reassure both myself and my family. When leaving the hospital for the first time and stepping outside into the fresh air, it was an emotional and symbolic moment as once again I have hope for the future"

Pharmaceutical company Novartis is one of the organisations working closely with teams at UH Bristol to deliver CAR-T therapy. Mari Scheiffele, Novartis Oncology General Manager, UK & Ireland said:

"As a pioneer of CAR-T, Novartis is proud to have collaborated so closely with University Hospital Bristol to deliver this truly individualised form of cancer therapy. We are proud of the close partnership that we have developed with the hospital team and hope that it will lead to positive outcomes for many patients."

CAR-T therapy is commissioned on the NHS nationally by NHS England. A panel of expert clinicians meets weekly to consider which patients are eligible for treatment from all of those who have been referred across the country and assigns them to a CAR-T cell centre for treatment.

Professor Steve Powis, NHS Medical Director, said:  

"CAR-T shows huge potential allowing NHS patients in England to be the first in the world to benefit from this revolutionary treatment which gives them new hope of survival.  

"This treatment marks the beginning of a new era of personalised medicine, and forms part of the upgrade and expansion of cancer services set out in the NHS Long Term Plan to ensure cancer survival rates remain at a record high."

 


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