Patients begin CAR-T cell treatment in pioneering trial

15 July, 2019

The Royal Marsden has been approved by NHS England to deliver a new type of immunotherapy for patients with relapsed or refractory diffuse large B-cell lymphoma.

Chimeric antigen receptor T cell (CAR-T cell) therapy uses the patient’s own immune system to fight cancer. It involves collecting patients’ own T cells, genetically modifying them to express a novel antigen receptor to enhance their ability to target and kill cancer cells, and then reinfusing them into the patient. The T cells are transferred to a manufacturing centre in the USA where they undergo genetic modification, before being returned to The Royal Marsden for reinfusion.

These CAR-T cells target the surface antigen CD19, which is expressed on the surface of lymphoma cells. Following the infusion of CAR-T cells into the patient’s blood, the novel antigen receptor allows them to directly bind to CD19, triggering T cells to kill the lymphoma cells.

A Phase III trial at The Royal Marsden, ZUMA-7, is comparing CAR-T cell therapy with the current standard of care in patients with diffuse large B-cell lymphoma that has relapsed or has been resistant to treatment. Thomas Romain, 27, was randomised to the CAR-T cell arm of the ZUMA-7 trial after his non-Hodgkin lymphoma became resistant to standard first-line chemotherapy.

“When I found out that not only was I eligible for this trial but it may also give me the chance to go into remission, I knew I had to give it a go.” Thomas Romain

Dr Emma Nicholson, Consultant Haematologist at The Royal Marsden, said: “CAR-T cell therapy has shown effectiveness in patients with multiply relapsed diffuse large B-cell lymphoma, who are resistant to standard chemotherapy options and have limited curative options.”  The Royal Marsden will be expanding the use of T cell therapies for patients with solid tumours later this year. with trials opening in renal carcinoma and melanoma.