What will CAR T-Cell Therapy for Paediatric ALL Treatment Mean to Africa?


Chimeric Antigen Receptor (CAR) T-Cell Therapy is a form of cancer immunotherapy which seeks to sharpen and strengthen the immune system’s inherent cancer-fighting powers.

CAR T-Cell Therapy was approved in August 2017 ~ the first time that the Food and Drug Administration (FDA) approved CAR T-cell therapy for a form of cancer ~ for the treatment of paediatric and young adult patients with B-cell ALL that has relapsed or hasn’t responded to previous treatments.

Acute Lymphoblastic Leukaemia (ALL) is a type of leukaemia in which a group of white blood cells, called lymphocytes, are affected. Leukaemia is the most common form of cancer in children, and about 80% of children with leukaemia have Acute Lymphoblastic Leukaemia.

CAR T-Cell Therapy involves treating patients with modified versions of their own immune system T cells ­– white blood cells that help protect the body from disease.

Lewis Silverman, MD, Clinical Director of the Hematologic Malignancy Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, said:

It’s a very exciting development in our ability to treat childhood ALL. It offers hope to those that we haven’t been able to treat with conventional therapy. This is a hugely exciting time in childhood leukaemia research”

 

Because the therapy is only approved for patients with relapsed or refractory ALL, Silverman says a future challenge will be to examine how CAR T-cell therapy could fit into the overall treatment of paediatric ALL patients – for example, whether it could be introduced early in patients who having a high risk of relapse.

 

Too Expensive?

Unfortunately, the cost of this type of treatment will be way beyond what many people can afford, as Novartis’ just-approved chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) is going to be introduced on the market at a price of $475,000 for a single infusion, an amount that is within the range anticipated by oncologists and that Novartis characterised as ‘well below a price level that could be justified on cost,’ according to their statement.

While both external and Novartis’ quantitative assessments of these values indicate that a cost-effective price could be $600,000 to $750,000, we recognize the importance of this paradigm-shifting therapy and are setting the price at $475,000 for this one-time treatment,” Dana Cooper, a spokesman for Novartis, said.

The $475,000 price for a single infusion of tisagenlecleucel does not include pre-infusion treatment cost, drug administration and hospitalization costs, or costs associated with adverse events and follow-up care. When those costs are added, the average total cost for 1 year of tisagenlecleucel is estimated to be $547,000, a figure that is based on experience from tisagenlecleucel clinical trials.

Prior to the FDA approval, outside estimates for what Novartis’ CAR T-cell therapy might cost ranged as high as $700,000. Cooper noted that the price Novartis has set for tisagenlecleucel is still below the cost of an allogeneic stem cell transplant.

The only potentially curative option for these pediatric and young adult patients is allogeneic stem cell transplant, which costs $500,000 to $800,000 for the first year,” Cooper said. “Additionally, stem cell transplant economic burden in subsequent years is high. With the potential to extend survival and improve quality of life, [tisagenlecleucel] can deliver significant societal value.”

Cooper said fewer inpatient and outpatient visits for treatment and fewer hospitalisations are likely to result from treatment with CAR T-cell therapy, which he said would allow parents and other family members and caregivers “to resume a normal life, including the possibility to return to work.”

The price may be high for CAR T-cell therapy, but it is important to weigh the costs against the potential benefits for patients, Gwen Nichols, MD, chief medical officer for the Leukemia & Lymphoma Society, said in an interview with OncLive. When children and young adults have their whole lives at stake, it’s easier to justify the expense of this new treatment.

Without CAR T-cell therapy, the costs of care, including a potential additional bone marrow transplant, are already “outrageously expensive,” Nichols said.

The real question is going to come when this therapy is poised to be expanded into other patients who are older, and providing the chance for 60 or 70 years of [additional] life is not what you’re talking about, and then we’re really going to have some tough value questions that we should be prepared to ask.”

While we are happy that new treatments are being discovered, unfortunately they really don’t mean much for those living in developing countries such as Africa, as most people will never see that amount of money in their entire lifetime, so there is NO WAY they will be able to afford these treatments.

At today’s exchange rate, the $547,000 price tag equals a WHOPPING R7,467,511.37  (that is 7.5 MILLION RAND!!!) WHO can afford THAT??

Someone, somehow needs to discover or invent a cure that WORKS and does not destroy the immune system in Children with Cancer, but that is affordable for poorer nations, or our children will continue to die.

It is time for Africa, and more especially for South Africa, to spend more money on research into Childhood Cancers and better methods of dealing with them!!

Where are our South African/African researchers???

 

 

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About LFCT

This is a blog about CHILDHOOD CANCER and CHILDHOOD CANCER AWARENESS Little Fighters Cancer Trust is a non-profit organisation that offers support and aid to Children with Cancer and their families. When a child is diagnosed with cancer it affects the whole family. One of the parents, usually the mother, must give up their job to care for the child and this creates financial problems for the family. In South Africa especially the majority of these families are not well-to-do; many of them are rural. A diagnosis of cancer can wipe out any family’s finances, let alone a poor family. The costs of special medications, special diets, hospital stays, transport to and from the hospital or clinic and accommodation and food costs for the mother who spends most of the time at her child’s bedside are astronomical. These are the people and problems that fall through the cracks, and these are the people that Little Fighters Cancer Trust has pledged to help in any way possible. LFCT takes a holistic approach to assisting the Children with Cancer and their Families, with the main aim to be the preservation of individual dignity and pride. Little Fighters Cancer Trust also focuses on promotion and advocacy of National Childhood Cancer Awareness in an effort to increase awareness of Early Warning Signs of Childhood Cancer. This would result in earlier diagnosis, giving the Child with Cancer more of a chance at Treatment and Survival. See "About" for more Background info

Posted on 12 October, 2017, in Blog, Cancer Treatments, Research, Videos and tagged , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

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