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You can find the current article at its original source at https://www.theguardian.com/commentisfree/2018/oct/05/nhs-cancer-treatment-biotherapeutics-funding
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| The NHS is revolutionising cancer treatment. Let’s back its mission | The NHS is revolutionising cancer treatment. Let’s back its mission |
| (about 1 month later) | |
| Theresa May’s announcement this week of a renewed NHS focus on diagnosing cancers earlier was warmly welcomed here at Cancer Research UK. Early detection and diagnosis is a key priority for us. A clear government ambition that within a decade 75% of cancer patients should be diagnosed at an early stage, when they still have options that can cure, would be great progress from where we are today. | Theresa May’s announcement this week of a renewed NHS focus on diagnosing cancers earlier was warmly welcomed here at Cancer Research UK. Early detection and diagnosis is a key priority for us. A clear government ambition that within a decade 75% of cancer patients should be diagnosed at an early stage, when they still have options that can cure, would be great progress from where we are today. |
| But should this ambition be realised, all patients still need treating – and, unfortunately, cancer can often evolve a stubborn resistance to the best therapies we currently have. | But should this ambition be realised, all patients still need treating – and, unfortunately, cancer can often evolve a stubborn resistance to the best therapies we currently have. |
| That’s why there’s an urgent need for more effective cancer treatments, and why another announcement this week is a great step forward: NHS England’s deal with a pharmaceutical company to make a revolutionary cancer therapy, known as CAR-T therapy, available to select adults with one of two specific forms of lymphoma, once all other treatments have stopped working. For the estimated 200 people who could benefit each year, who have just months to live, this will be a lifeline. | That’s why there’s an urgent need for more effective cancer treatments, and why another announcement this week is a great step forward: NHS England’s deal with a pharmaceutical company to make a revolutionary cancer therapy, known as CAR-T therapy, available to select adults with one of two specific forms of lymphoma, once all other treatments have stopped working. For the estimated 200 people who could benefit each year, who have just months to live, this will be a lifeline. |
| The announcement follows swiftly on the heels of similar news last month that CAR-T will be made available to children with an aggressive form of leukaemia. The NHS and the manufacturers deserve credit for introducing this highly complex technology so swiftly. It puts the NHS at the forefront of innovation adoption. | The announcement follows swiftly on the heels of similar news last month that CAR-T will be made available to children with an aggressive form of leukaemia. The NHS and the manufacturers deserve credit for introducing this highly complex technology so swiftly. It puts the NHS at the forefront of innovation adoption. |
| But alongside their undoubted promise, the new generation of cancer treatments – collectively known as “biotherapeutics” and exemplified by CAR-T – are posing a new set of issues. | But alongside their undoubted promise, the new generation of cancer treatments – collectively known as “biotherapeutics” and exemplified by CAR-T – are posing a new set of issues. |
| In the case of CAR-T therapy, the treatment is made by extracting immune cells called T-cells from a patient’s blood. Normally, T-cells scan our bodies for a range of potential problems. With CAR-T, the extracted cells are genetically modified to seek out a single target – a molecule called CD19 found on the surface of certain leukaemia and lymphoma cells – then multiplied a thousand-fold and put back into the patient’s bloodstream. It’s the ultimate in personalised medicine, engineering patients’ own immune systems into precision anti-cancer weapons. Slowly, we’re learning how to outsmart cancer. | In the case of CAR-T therapy, the treatment is made by extracting immune cells called T-cells from a patient’s blood. Normally, T-cells scan our bodies for a range of potential problems. With CAR-T, the extracted cells are genetically modified to seek out a single target – a molecule called CD19 found on the surface of certain leukaemia and lymphoma cells – then multiplied a thousand-fold and put back into the patient’s bloodstream. It’s the ultimate in personalised medicine, engineering patients’ own immune systems into precision anti-cancer weapons. Slowly, we’re learning how to outsmart cancer. |
| But with this complexity comes significant challenges. The intricate manufacturing process can only currently be carried out by a handful of labs worldwide, meaning that, in practice, UK patients’ cells must make a long, sterile journey to a faraway lab and back. This centralisation also means the numbers who can be treated is limited, and the prospect of an “off-the-shelf” version is a long way off. | But with this complexity comes significant challenges. The intricate manufacturing process can only currently be carried out by a handful of labs worldwide, meaning that, in practice, UK patients’ cells must make a long, sterile journey to a faraway lab and back. This centralisation also means the numbers who can be treated is limited, and the prospect of an “off-the-shelf” version is a long way off. |
| Once engineered, the treatment also requires considerable expertise to administer, and can cause severe side-effects. We know that the NHS expects a substantial minority of patients to spend time in intensive care – something many might feel worthwhile for a possible cure, but a significant factor to consider. | Once engineered, the treatment also requires considerable expertise to administer, and can cause severe side-effects. We know that the NHS expects a substantial minority of patients to spend time in intensive care – something many might feel worthwhile for a possible cure, but a significant factor to consider. |
| So what to do? The NHS has recognised biotherapeutics’ potential and committed to support their introduction – it’s a forward-thinking stance when budgets are so tight. It plans to have UK-based cell-therapy facilities up and running as soon as possible, starting small, learning as they go, and gradually building capacity and expertise. | So what to do? The NHS has recognised biotherapeutics’ potential and committed to support their introduction – it’s a forward-thinking stance when budgets are so tight. It plans to have UK-based cell-therapy facilities up and running as soon as possible, starting small, learning as they go, and gradually building capacity and expertise. |
| We’re fortunate that the NHS can build on an excellent platform. Its existing cell-therapy facilities – used to perform stem-cell transplants – are world-class and situated in top cancer centres around the country, making the UK an extremely attractive place to do research and develop new biotherapeutics. This is a status we must protect and build upon as the UK heads towards the EU’s exit door. | We’re fortunate that the NHS can build on an excellent platform. Its existing cell-therapy facilities – used to perform stem-cell transplants – are world-class and situated in top cancer centres around the country, making the UK an extremely attractive place to do research and develop new biotherapeutics. This is a status we must protect and build upon as the UK heads towards the EU’s exit door. |
| At Cancer Research UK, we’re pioneering new approaches too, and recently announced two initiatives to accelerate biotherapeutics research. We’re investing £14m in a new centre in London, bringing together expertise from UCL, the Francis Crick Institute, Queen Mary University of London and King’s College London to create a global centre of excellence in biotherapeutics. And we’ve launched an international partnership with our sister organisations in Italy and Spain, injecting £30m into a range of new projects, among them an international consortium to improve CAR-T technology, hopefully making it cheaper and more reliable. | At Cancer Research UK, we’re pioneering new approaches too, and recently announced two initiatives to accelerate biotherapeutics research. We’re investing £14m in a new centre in London, bringing together expertise from UCL, the Francis Crick Institute, Queen Mary University of London and King’s College London to create a global centre of excellence in biotherapeutics. And we’ve launched an international partnership with our sister organisations in Italy and Spain, injecting £30m into a range of new projects, among them an international consortium to improve CAR-T technology, hopefully making it cheaper and more reliable. |
| But there is, of course, the elephant in the room: whether it be diagnosing or treating cancer, the NHS is currently struggling under a range of pressures, including substantial staff shortages. Commitments and new technologies are all very well, but until these pressures are alleviated, the UK will struggle to keep up with its neighbours in terms of survival rates. We need urgent action on this front – our patients deserve no less. | But there is, of course, the elephant in the room: whether it be diagnosing or treating cancer, the NHS is currently struggling under a range of pressures, including substantial staff shortages. Commitments and new technologies are all very well, but until these pressures are alleviated, the UK will struggle to keep up with its neighbours in terms of survival rates. We need urgent action on this front – our patients deserve no less. |
| • Dr Iain Foulkes is Cancer Research UK’s executive director of research and innovation | • Dr Iain Foulkes is Cancer Research UK’s executive director of research and innovation |
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