Eligibility
Commercial CAR T-cell treatments are available in Australia for:
- Adults with diffuse large B-cell lymphoma (a type of non-Hodgkin's lymphoma) that does not respond to, or has relapsed after, two or more systemic therapies.
- Children and young adults (up to 25 years old) with acute lymphoblastic leukaemia that does not respond to standard treatment, in relapse post-transplant, or in second or later relapse.
More information on the eligibility criteria for clinicians
If a patient is not eligible for CAR T-cell therapy, there may be other treatments available through a clinical trial. Visit Australian Clinical Trials for more information.
Referral
NSW Health has established four treating centres for the delivery of commercial CAR T-cell therapies.
| Treating centre | Indication |
|---|---|
| Sydney Children's Hospital, Randwick | Acute lymphoblastic leukaemia (< 18 years old) |
| The Children’s Hospital at Westmead | |
| Royal Prince Alfred Hospital | Acute lymphoblastic leukaemia (≥ 18 years ≤ 25 years old) Diffuse large B-cell lymphoma |
| Westmead Hospital |
Other treatments and studies
The first generation of CAR T-cell treatments have focused on the B-cell antigen CD19. There are several studies worldwide looking at alternative antigens and diseases (e.g. B-cell maturation antigen in multiple myeloma). Treatments using other lymphocyte subtypes (e.g. natural killer cells) to target cancer cells are also being explored.
The current TGA approved CAR T-cell treatments are manufactured from T-cells collected from the patient (autologous). Studies are investigating the advantages of cells manufactured from a donor (allogeneic). These so called “off the shelf” products may be more accessed quickly.
Antigen specific T-cells
There are currently several studies focusing on the use of antigen specific T-cells. Researchers in NSW are leading in this area of medicine.
T-cells can be manufactured from existing blood and marrow transplant products (autologous and allogeneic) or obtained from a cell bank. Research is focused on the effectiveness of T-cells targeting individual antigens (e.g. cytomegalovirus) or a combination of antigens (e.g. multi-virus). These treatments have shown promise in treating and preventing disease. These products are available as part of clinical trials. Visit Australian Clinical Trials for more information.