MIAMI: US regulators on Wednesday (Thursday in Manila) approved the first gene therapy against cancer—a treatment that uses a patient’s own immune cells to fight leukemia—opening a new era in the fight against one of the world’s top killers.
The treatment is made by Novartis and is called Kymriah (tisagenlecleucel).
This type of anti-cancer immunotherapy, known as a CAR-T cell therapy, was known by CTL019 until now.
“This marks the first-ever CAR-T cell therapy to be approved anywhere in the world,” Novartis CEO Joseph Jimenez told reporters on a conference call.
“It uses a new approach that is wholly personalized by using a patient’s own T-cells.”
Kymriah was approved by the US Food and Drug Administration for children and young adult patients up to age 25 with a form of acute lymphoblastic leukemia (ALL).
To qualify for treatment, patients must have B-cell precursor ALL that is refractory, or the patient has relapsed at least twice.
The FDA described the approval as “a historic action” and a “new approach to the treatment of cancer and other serious and life-threatening diseases,” said a statement.
How it works
The treatment is not a pill or a form of chemotherapy, which can weaken the body’s natural defenses.
Instead, it harnesses a patient’s own immune cells, called T-cells and white blood cells, and trains them to recognize and fight cancer.
The patient’s immune cells are removed with a special blood filtration process, sent to a lab, and genetically encoded to be able to hunt down cancer cells.
These re-engineered T-cells are then transfused back into the patient, where they can begin attacking leukemia.
Studies have shown that 83 percent of patients responded to the treatment, achieving remission within three months, Novartis said.
An application with the European Medicines Agency is expected to be filed by the end of the year.
$475,000 a dose
The price of Kymriah—which is delivered to a patient just once—is $475,000, said Bruno Strigini, CEO of Oncology at Novartis.
Patients who do not respond to the treatment within the first month would not be expected to pay, he told reporters.
The more common treatment for leukemia—bone marrow transplants—can cost between $540,000 and $800,000 the first year in the United States, Strigini said.
Meanwhile, outside analyses have set a cost-effective price for Kymriah between $600,000 and $750,000, he added.
“Recognizing our responsibility we set the price below that level,” said Strigini.
Most patients who fit the criteria for treatment would likely be covered by insurance, since they are under 25 and would either be on their parents’ insurance or covered by government-sponsored Medicaid, a Novartis spokesman said.
The price tag is high—as are costs throughout the cancer industry—a trend that is “unsustainable,” said Craig Devoe, acting chief of medical oncology and hematology at Northwell Health Cancer Institute in New York.