People with an aggressive form of blood cancer have been given new hope as two new drugs are set to be launched on the NHS.
The drugs, epcoritamab and loncastuximab tesirine, were approved by the NHS spending watchdog within two days of each other, representing a lifeline for patients living with a type of non-Hodgkin’s lymphoma that kills four in ten within within five years after diagnosis.
Each year, around 5,500 Britons are told they have diffuse large B-cell lymphoma (DLBCL). The condition occurs when some of the body’s immune cells, known as lymphocytes, do not work properly and build up in lymph nodes or other parts of the body. It commonly manifests as swollen glands in the neck, unexplained weight loss, night sweats, and painless lumps on the body.
Following the drugs’ approval, NHS doctors can now give DLBCL patients epcoritamab or loncastuximab tesirine when their cancer has not responded to at least two other treatments.
Diffuse large B-cell lymphoma occurs when some of the body’s immune cells, known as lymphocytes, do not work properly and build up in lymph nodes or other parts of the body (file photo)
Epcoritamab, sold under the brand name Tepkinly, is administered through monthly injections. It is what is known as a bispecific antibody: a protein that recognizes and attaches to cancer cells, helping the body fight the disease.
Loncastuximab tesirine, however, is an antibody-drug conjugate, which is administered by drip and works by seeking out proteins on the surface of cancer cells and delivering chemotherapy to the tumor to kill them.
Epcoritamab, sold under the brand name Tepkinly, is administered through monthly injections. It is what is known as a bispecific antibody: a protein that recognizes cancer cells and adheres to them, helping the body fight the disease.
One study showed that 39 percent of patients who received the treatment were cancer-free after just ten months.
Loncastuximab tesirine, however, is an antibody-drug conjugate, which is administered by drip and works by seeking out proteins on the surface of cancer cells and delivering chemotherapy to the tumor to kill them.
Dr Dima El-Sharkawi, a consultant hematologist at the Royal Marsden NHS Foundation Trust in London, says the drugs could offer a solution to a fifth of people with DLBCL for whom no other treatment has worked.
The outlook for these patients is bleak and they often die within months. The standard treatment for DLBCL is known as R-CHOP, a combination of chemotherapy and an immune system-boosting cancer treatment called immunotherapy, which trains the body to protect itself from cancer.
Currently, this cures about half of DLBCL patients, but the rest of the sufferers have to look for alternative options, such as a stem cell transplant, formerly known as a bone marrow transplant.
This procedure involves collecting stem cells from the patient or a donor from their bone marrow, the spongy tissue inside our bones responsible for producing red blood cells and white blood cells of the immune system.
These are multiplied in a laboratory before being injected into the patient in the hope that they will prevent the body from producing the defective white blood cells that characterize blood cancers such as DLBCL.
More recently, patients have been offered CAR-T therapy, which modifies immune system cells to attack cancer cells.
However, some people are too frail to cope with its side effects (which can include breathing problems, fever, low blood pressure and vomiting) and around half of patients who opt for the treatment see their cancer return.
Dr El-Sharkawi says: ‘There has been an explosion in terms of treatment options for DLBCL. “All it takes for each patient is for one of these medications to work.”
Alexander Gudmestad, 34, first received his “devastating” DLBCL diagnosis in the spring of 2020 in his native Norway, after discovering several lumps in his neck.
The filmmaker, who now lives in Reigate, Surrey, with his wife Lottie, says: “I thought it was probably a cold, but the lumps kept getting bigger. “I had had testicular cancer as a child, so I knew I should go to the doctor. header quickly.’
Alexander’s doctors in Norway began treating him with R-CHOP with initial success, but the cancer returned the following year. He had several more rounds of treatment, including more chemotherapy and a stem cell transplant, but the cancer kept coming back.
In 2022, Alexander moved to England and underwent CAR-T therapy on the NHS at the Royal Marsden Hospital NHS Trust. The cancer returned that same year, and Alexander began epcoritamab in October.
He adds: “We didn’t know if it was going to work, so I didn’t want to put my hopes on it.”
But a scan last month revealed the “very good news” that the treatment is working and Alexander is now cancer-free.
“I am very happy that it is working and I will continue with the treatment as long as it works,” he adds. ‘I can live quite normally with the disease and the treatment as long as it works, which was not an option before.
“If I was in the same situation two years ago, there would have been no hope.”