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NCCP chief urges HSE to make arrangements for patients requiring CAR-T cell therapy

By Paul Mulholland - 19th Sep 2019

The Director of the National Cancer Control Programme (NCCP) recently made an appeal to senior HSE management to fund and arrange treatment for patients requiring chimeric antigen receptor (CAR) T-cell therapy, the Medical Independent (MI) can report.

In an email to HSE General Manager Ms Catherine Donohoe, on 20 June 2019, seen by MI through Freedom of Information law, Dr Jerome Coffey noted that three applications to access the treatment had been submitted to the treatment abroad scheme.

The three applications comprised two paediatric leukaemia patients and one adult lymphoma patient.

Dr Coffey wrote that all have been assessed, “to varying degrees”, by Great Ormond Street Hospital in London, and University College London Hospitals NHS Foundation Trust and were deemed appropriate for treatment.

“Notwithstanding the ongoing appraisal process, the cost of this treatment option and all other related issues I feel that this is the clinically appropriate option for these patients and I would be grateful if you would assist with the necessary arrangements for the patients and their families,” stated Dr Coffey.

The CEO’s Office, the Chief Finance Officer, the Chief Operations Officer, and Director of Acute Operations were also cc’d in the mail.

Chimeric Antigen Receptor (CAR) T-cell therapy involves genetic modification of patients’ autologous T-cells to express a CAR specific for a tumour antigen, following by ex vivo cell expansion and re-infusion back to the patient.

This T-cell genetic modification may occur either via viral-based gene transfer methods or nonviral methods, such as DNA-based transposons, CRISPR/Cas9 technology or direct transfer of in vitro transcribed-mRNA by electroporation.

A spokesperson for the HSE told MI that the patients in question were approved to travel abroad for treatment.

The spokesperson added that further applications for the treatment have also been made.

When asked about the appraisals process, the spokesperson stated: “CAR-T cell therapy is a drug and is being assessed under the HSE reimbursement process. The duration of the assessment varies.”

Currently two Irish hospitals are preparing to provide CAT-T cell therapy – St James’s Hospital, Dublin, and Children’s Health Ireland, Crumlin.

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