More cutting-edge cancer therapies are moving through the clinical trial pipeline into major treatment centres, giving patients in NSW access to innovative treatment options.
While cellular therapies traditionally replaced healthy cells after chemotherapy, they can now be programmed to actively destroy diseases. These chimeric antigen receptor (CAR T) cell therapies can improve long-term remission and survival for patients with blood cancers such as leukemia, lymphoma and myeloma. CAR T-cell therapy is an innovative immunotherapy where a patient’s own T-cells are removed, genetically programmed to target cancer cells, then reintroduced into the patient’s body to fight the disease.
Clinical trials have led to rapid progress in CAR T-cell therapy worldwide and have given patients in the NSW health system the ability to access potentially lifesaving treatments years before they would be available as usual care.
In a relatively short time, several CAR T-cell therapies have progressed to being offered as standard of care treatments in NSW. These treatments are available through the NSW CAR T-cell therapy specialist centres at Royal Prince Alfred (RPA) and Westmead hospitals, the Sydney Children’s Hospital Network, and expanding to Royal North Shore and Liverpool hospitals in 2026/27.
Currently around 150 patients each year receive approved CAR T-cell therapy for blood cancers (up from around 20 patients in 2020), with approximately another 100 patients taking part in clinical trials at major centres plus additional hospital sites.
Setting the standard for leading care
More than 50 cellular therapy clinical trials are underway across the NSW health system, with an increasing number of commercial trials joining investigator-led trials.
“Clinical trials have allowed NSW hospitals to create the infrastructure and capability needed to deliver cellular therapies, including CAR-T and other immune effector cell treatments,” explains ACI Blood and Marrow Transplant + Cellular Therapies (BMT+CT) Network Medical Co-chair Dr Edward Abadir, Director of Cellular Therapies at RPA and Staff Specialist Haematologist at RPA and Chris O’Brien Lifehouse.
The BMT+CT Network aims to improve the experience and delivery of healthcare for patients accessing these services across the state. The network plays a key role in underpinning the standard of cellular therapy treatment in NSW by:
- maintaining a statewide quality management system
- providing onsite auditing and support for system development
- supporting adoption of international accreditation standards
- fostering ongoing clinician education and professional development
- providing education and resources for consumers
- supporting safe and effective implementation through centralised policies and outcome monitoring.
“This rigorous environment increases the appeal for international clinical trials to base their work in NSW,” adds Dr Abadir.
Ongoing partnership between the BMT+CT Network, the Ministry of Health and hospitals helps to ensure that knowledge is shared and resources are used efficiently, allowing the maximum number of patients to benefit from cellular therapies across the state.
“The successful delivery of CAR T-cell therapy as an established NSW health service relies on strong collaboration between the Ministry of Health, local health districts and the ACI BMT+CT Network. The network plays a vital role in helping to ensure these complex therapies are delivered safely and effectively for patients across NSW,” says the Olivia Hibbitt, the Ministry's Director of Specialty Services and Technology Evaluation.
The future of cellular and gene therapies
While most CAR T-cell treatments have centred on blood cancers, new trials are enrolling patients with other cancers, including bowel cancer and metastatic melanoma. For the first time, CAR T-cell trials are also providing patients with auto-immune diseases, such as multiple sclerosis and myasthenia gravis, a long remission without continuous medication. CAR approaches are also being tested in other immune cell types, including natural killer cells. The next step is being able to provide the treatment as a gene therapy without the need to process cells in a laboratory.
Gene therapies that directly manipulate genes inside the patient, rather than transplanting them, are an emerging and exciting area of technology. These can be used to treat patients born with inherited, previously incurable conditions, as well as cancer.
As demand for cellular therapies grows, NSW is also building local manufacturing capability to support future access to CAR T-cell and other advanced therapies. By strengthening local cellular processing capability, as well as infrastructure for gene therapy manufacturing including viral vectors and ribonucleic acid (RNA), there is the potential to improve system sustainability and position NSW to adopt new treatments as they become available.
More about Blood and Marrow Transplant + Cellular Therapies Network.
Related resources
- Learn more about the NSW Health Immune Effector Cell Service
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