The May reimbursement list included two highly anticipated treatments: polatuzumab vedotin and Car-T for patients with refractory and relapsed B-cell lymphoma who had no previous treatment options.
Good news for people with B-cell lymphoma
Published April 28, 2022 08:22
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- So far, there have been no treatment options for these patients. That is why these therapies are groundbreaking - told Medexpress prof. Iwona Hus, deputy head of the Hematology Clinic of the Institute of Hematology and Transfusion Medicine in Warsaw, president of the Polish Society of Hematology and Transfusion Medicine.
Expected decision
Until a few years ago, medicine did not have much to offer a group of patients with refractory and relapsed B-cell lymphoma who were not eligible for autologous transplant. In 2020, polatuzumab vedotin was registered in the EU, a year later the therapy was positively assessed by AOTMIT, and from now on it will be available to Polish patients. The indications for CAR-T therapy for patients with large B-cell lymphoma have also been extended.
The most common lymphoma
Large B-cell lymphoma is the most common type of lymphoma. It is an aggressive and rapidly progressing high-grade neoplasm. It occurs in both younger and older patients, although the risk of developing the disease increases with age. As clinicians emphasize, the goal of therapy is permanent cure.
Relapse and resistance patients
- The combination of chemotherapy with anti-CD20 monoclonal antibody, used so far in the first line, allows to cure about 60-70% of patients. sick. The remaining patients have relapsed or are resistant to disease. The prognosis of this group of patients is very bad - explains Prof. Sebastian Giebel, head of the Clinic of Bone Marrow Transplantation and Oncohematology at the Gliwice branch of the Oncology Center - Instytut im. Maria Skłodowskiej-Curie. Due to their age and accompanying diseases, most of these patients are not eligible for transplant.
Rescue for patients
According to prof. Wojciech Jurczak, head of the Lymphatic System Cancer Treatment Unit at the Clinical Oncology Clinic of the National Oncology Institute. Maria Skłodowskiej-Curie - National Research Institute, president of the board of the Defeat Lymphoma Foundation, a breakthrough in treatment has become possible. Polatuzumab vedotin is a form of immunotherapy using monoclonal antibodies, but coupled with a toxin molecule.- On the one hand, we have a protein that recognizes the antigen on lymphoma cells, and on the other, a toxin that is attached to it and which, after recognizing a cancer cell, contributes to its destruction - explains prof. Giebel.
Defeat the dragon
- The mechanism of action of the drug is simple, reminiscent of the way in which the shoemaker Dratewka defeated the Wawel dragon. Like a sheep filled with sulfur - the antibody combined with the toxin released only in the center of the cancer cell destroys it. We have few side effects, because we administer the drug with surgical precision - adds prof. Jurczak.
Prof. Giebel points out that some patients can be cured in this way, and the rest can be treated with the next line of treatment, such as CAR-T.
