First patients treated with CAR T therapy

21 June 2019 - King’s College Hospital has been treating adult patients with the pioneering new treatment

Dr Victoria Potter and Mike Simpson

King’s College Hospital in south London has become the first hospital in the UK to use the newly approved CAR T (chimeric antigen receptor T-cell) therapy to treat adult patients with lymphoma.

CAR T therapy is a complex immunotherapy that is personally developed for each individual patient. It involves harvesting T cells – the immune cells that recognise and kill viruses – from the patient, reprogramming them to recognise cancer cells, and infusing them back into the patient so they attack the cancer.

Currently, CAR T therapy is being used on selected patients at King’s with a recurrence of lymphoma – a cancer that begins in the infection-fighting cells of the immune system. These cells are found in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body.

Dr Reuben Benjamin, Consultant Haematologist at King’s, who led the clinical trial that delivered the first CAR T cell therapy at King’s said, “King’s has long been at the forefront of pioneering new treatments for blood conditions so we are delighted to be offering CAR T therapy. It has been shown in trials to cure some patients, even those with advanced cancers, when other treatments have failed.”

The treatment is effective in around 40-50% of cases, including patients who did not respond well to chemotherapy, but has a unique set of side effects, including neurotoxicity, in the short-term. Dr Benjamin added, “Patients who receive the treatment can experience a range of unpleasant side effects from high fever; vomiting; and diarrhoea to confusion; aphasia (difficulty understanding or speaking); and loss of consciousness.”

King’s has been at the forefront of this therapy by bringing together researchers and clinicians as part of King’s Health Partners, turning the latest research into pioneering new treatments for patients.

As a result of this partnership, all CAR T patients are screened for anxiety and depression. Any patient showing symptoms will receive mental health support to cope with the difficult effects of the treatment. This makes King’s unique as no other UK hospital offering CAR T therapy joins up physical and mental health treatment in this way.

One of the first patients to receive the treatment was 62-year-old Mike Simpson, a solicitor from Durham. The married father-of-two was diagnosed with stage 4a Diffuse Large B-Cell Lymphoma, a fast-growing form of blood cancer, in 2015 after discovering a lump in his neck. He underwent chemotherapy and radiotherapy at his local hospital and went into remission. Ten months later, he relapsed and was treated again. After going into remission for a second time, the cancer returned.

Mike said, “In October 2018, I began experiencing back pain, stomach discomfort and severe vomiting so I went for more tests and was given the news the cancer was back. Dr Wendy Osborne and colleagues at the Northern Centre For Cancer Care (NCCC), Freeman Hospital Newcastle, explained CAR T therapy, which looked very promising so when I was given the opportunity to have the therapy at King’s I jumped at it, and I am very grateful the team at NCCC put me forward.”

Mike came to King’s in late 2018 for pre-assessment and had his cells harvested in early January 2019. While they were sent to the USA for modification, Mike was given ‘holding’ treatment to ensure his lymphoma remained under control as this process takes four weeks. Once the CAR T cells were manufactured, he was given conditioning chemotherapy to prepare for the infusion of modified T cells, which he received in February.

Mike said, “The team at King’s explained all about the treatment and possible side effects. Despite this, it still came as a big shock to me and my family when I became unwell a few days after the infusion. It was no walk in the park. I spent almost a week in intensive care and when I was well enough to be moved back to the ward I had to re-learn basic tasks such as climbing stairs. I was fortunate to have the support of my wife and children, who had to watch me go through the changes hoping all the time they would be temporary.”

Despite the initial adverse reaction to the therapy, Mike has responded well to the treatment and is working towards remission. He is back at home, spending time with his young grandchildren and regaining his strength. Mike is hopeful for the future, including a return to work, but recognises how lucky he is. “I’m incredibly grateful for being given the opportunity to have this therapy as I know it’s a costly, one-time treatment. I describe it as my L’Oreal treatment… because I’m worth it,” he joked.

Dr Victoria Potter, Consultant Haematologist and Director of Stem Cell Transplantation at King’s, said, “In cases such as Mike`s, CAR T therapy is a last resort when other treatments have failed. Although it does not work for everyone, from what we have observed in clinical trials this type of personalised medicine offers real hope for lymphoma patients who otherwise would have limited options. We are very hopeful this treatment will be a game-changer for our patients.”

The NHS is providing CAR T therapies for children and young people with B cell acute lymphoblastic leukaemia, and adults with diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma in England.

Simon Stevens, Chief Executive of NHS England and NHS Improvement said, “CAR-T shows huge promise and it is fantastic to see that patients in the NHS are among the first in the world to benefit. The start of this treatment marks the beginning of a new era of personalised medicine, and forms part of the upgrade in cancer services which are set out in the NHS Long Term Plan.”

A panel of expert clinicians decides which patients are eligible for treatment.


For further information please contact:
Karen Welsh
Head of Communications
karen.welsh2@nhs.net
Extension: +44 (0)20 3299 3850

Notes to editors

1. For further information or interview bids for King’s clinicians or Mike Simpson contact:
Karen Welsh, Corporate Communications, King’s College Hospital NHS Foundation Trust. Tel: 020 3299 3257; e-mail: karen.welsh2@nhs.net

2. King’s College Hospital is a centre of excellence for haematological conditions including lymphoma, leukaemia, myelodysplastic syndromes, aplastic anaemia and sickle cell disease.

3. Mike Simpson received the Yescarta product, manufactured by Kite, a Gilead company.

4. NHS England struck the first full access deal in Europe on tisagenlecleucel, which can potentially cure some children with B cell acute lymphoblastic leukaemia (ALL) where other treatments have failed, enabling NICE to recommend the treatment for entry into the reformed NHS Cancer Drugs Fund last week.

5. The landmark deal with Novartis came less than 10 days after the treatment was granted its European marketing licence and represents one of the fastest funding approvals in the history of the NHS.

6. Both products are now licenced for lymphoma.

7. King’s College Hospital NHS Foundation Trust is one of the UK’s largest and busiest teaching hospitals. The Trust is recognised internationally for its work in liver disease and transplantation, neurosciences, cardiac, haemato-oncology, fetal medicine, stroke and major trauma. In 2013, we acquired the Princess Royal University Hospital (PRUH), Orpington Hospital, and some services at Beckenham Beacon and Queen Mary’s Sidcup following the dissolution of South London Healthcare NHS Trust. We now provide care to 1.5 million patients in Southwark, Lambeth, Bromley, Bexley, Lewisham and elsewhere in south east London and parts of Kent. Over 10,000 babies are delivered by our hospitals each year, and over 750 patients come to our Emergency Departments every day. For more information, please visit the website - www.kch.nhs.uk. You can also support the work of King’s College Hospital at supportkings.org.uk.

8. King’s Health Partners is an Academic Health Sciences Centre (AHSC) - a pioneering collaboration between King’s College London, and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts. The partnership seeks to improve care for patients by turning breakthroughs in medical science into cutting edge treatment at the earliest possible opportunity.

9.The King’s Health Partners Haematology Institute works within the AHSC to bring together the specific strengths of the partners in clinical service, research, and education and deliver exceptional outcomes for haematology patients. Our vision is to develop cures and vaccinations for haematological conditions so that future generations do not have to face lives with these diseases.

10. The Leukaemia UK Mind and Body programme is focused on integrating physical and mental healthcare systems enabling us to regard mental and physical conditions equally and simultaneously. Patients who are under our care for Stem Cell Transplant and CAR-T are offered routine screening to identify and address psychological factors that impact on mental and physical health and wellbeing.

11. At King’s College Hospital we fundraise for the best in treatment, research and health education, leading-edge equipment and improving well-being in our communities. By uniting doctors, nurses, researchers and academics with our supporters and volunteers we can provide the best patient care that goes above and beyond. Find out more and support us at supportkings.org.uk