EBMT-EHA CAR-T 2019 | The roll-out of CAR T-cell therapy in the UK

Graham Collins

In this video, Graham Collins, MBBS, MRCP, FRCPath, DPhil, of the Oxford University Hospitals NHS Foundation Trust, Oxford, UK, explains how the NHS in the UK have handled the roll-out of CAR T-cell therapy to date. Speaking at the 1st European CAR T-Cell Meeting, held in Paris, France, Dr Collins mentions the importance of pooling together the experience from centers in order to ensure correct protocols are in place for adverse events, and that patients are directed to the right centers in a timely manner.This meeting was co-organized by the European Society for Blood & Marrow Transplantation (EBMT) and the European Hematology Association (EHA).

Transcript (edited for clarity):

I feel quite proud, actually of how the UK are handling the roll-out of CAR T-cells. I think it was one of the first socialized health care systems to approve and start rolling out CAR T-cells. It’s happening very quickly, which, in one sense is great, because we have patients who need it. The demand is there. But, on the other hand, there are problems with that, challenges. One challenge, for example, is do we have simply the patient information? Written patient information, written in lay-language that’s been through patient representatives to check it and make sense, have we got that in place? I’m not sure we always do.

Simple things like that. We may be running slightly ahead of ourselves, but, as I say, that’s potentially good that our patients are getting access. Great that that’s happening. I like the way, as well, that NHS England are doing a phased roll out. In my institution, for example, we’re not a CAR T-cell center, yet. I don’t think we would really expect to be. But, there is a second wave now, that we’ve sort of held up our hand to apply for that. We may or may not be a second wave, but I think that NHS England are being very realistic that, if this therapy does deliver on the promises, and it may become available in a number of different indications. We’re going to eventually, almost certainly have quite a few centers in the UK, but it’s making sure it happens safely, making sure the quality assurance is in place, making sure there’s training expertise.

I think one key thing going forward, and I’m not yet convinced this is happening; is that we pool our experience in the UK so that the first wave of centers are sharing their experiences together, but also with the second wave as they open. Making sure we’ve got the right protocols to manage complications. Also, how do we make sure the patients are going tot he right centers in a timely way, within a U.K. context? There’s still things to learn, I think. But, it’s very exciting.

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