British Columbia has adopted an emerging immunotherapy to fight blood-related cancers, offering new hope to those who have not responded to conventional forms of treatment.
During initial implementation, up to 20 eligible adult patients and five eligible pediatric patients per year will receive chimeric antigen receptor T-cell (CAR-T) therapy in-province as standard of care treatment, announced Premier David Eby and Health Minister Adrian Dix at a news conference on Sunday.
Patient intake began in January, and the first treatment is expected to start this month. The therapy had previously been limited to clinical trials and sending patients out of country. Ontario, Quebec and Alberta also fund CAR-T therapy for a limited number of patients.
“Leukemia and lymphoma patients will be able to access CAR-T therapy at Vancouver General Hospital, and younger patients will get treatment at BC Children’s Hospital,” Mr. Eby said.
“It is truly a miracle of modern science and medicine, and it’s available for patients right here in British Columbia.”
CAR-T therapy involves extracting a patient’s immune cells, called T-cells, genetically engineering them to recognize a protein on cancer cells and infusing them back into the patient’s bloodstream. The CAR T-cells are then able to recognize and kill cancer cells in the patient’s body. It is only used when conventional cancer treatments, such as chemotherapy and radiation, have not been successful.
The Globe and Mail reported last year that this process is expensive and can take more time than severely ill patients have, given that most existing CAR-T therapies required either the patients travel out of country, or that their cells be sent to facilities in the U.S.
In 2016, Canadian researchers – including those at BC Cancer, the Ottawa Hospital Research Institute and the BioCanRX research network – established a network called Canadian-Led Immunotherapies in Cancer. In 2019, it launched a clinical trial involving the manufacturing of CAR-T cells in Canada, opening the door to what they believe will be less expensive and easier to access treatment.
The province’s 2024 budget earmarks $90-million – $270-million over three years – for its 10-year cancer plan. While per patient costs for CAR-T therapy will vary, B.C.’s Ministry of Health is anticipating an initial investment of $14-million to deliver the therapy, which includes hiring about 10 full-time equivalent staff, with nine already hired.
At Sunday’s news conference, BC Cancer chief medical officer Kim Chi said the therapy is an example of how far cancer treatments have evolved, driven in large part by research in the province.
“Before we can offer CAR T-cell therapy as a standard of care, our teams have spent years developing the expertise and infrastructure needed to deliver and create these genetically engineered immune cells to patients,” he said.
B.C.’s Ministry of Health said Sunday that it is using a made-in-Canada CAR T-cells and will assess transitioning to a B.C.-made product when clinical trials are complete.
Also at Sunday’s news conference was Mary-Jill Asrat, whose son, Hugo, was diagnosed with leukemia at two years old. Despite years of intense treatments including chemotherapy, traces of leukemia persisted in his bone marrow.
Ms. Asrat said she and her husband were feeling defeated when their oncologist told them about one other option called CAR-T.
“Thirteen days later, early in the morning while Hugo was still sleeping, our oncologist stepped into our room and he simply passed us a piece of paper, which was Hugo’s biopsy results, and in the corner there was a little hand-drawn happy face,” she told the news conference. “Hugo had no detectable trace of leukemia in his bone marrow.”
The therapy significantly increased the odds of a successful bone marrow transplant, with Hugo’s big brother as the donor, Ms. Asrat said. Behind her stood the two curly-haired boys, flanked by their father; Hugo is now eight years old and cancer-free.
The Globe has reported extensively on the pressures on B.C.’s cancer care system, owing in part to the province’s growing and aging population.
Mr. Dix said Sunday that the challenges ahead are “real and significant at every level,” noting that B.C. will go from 30,000 people diagnosed with cancer each year to 44,000 by 2034.
Andrea Woo