CAR-T Therapy

I've just had my three monthly check-up, the first one with my new Consultant. Blood test results and examination ok, all appears to be stable.

I asked him about treatment options at next relapse. Assuming of course my lymphoma doesn't transform, which is always a risk. He very clearly said I could have Bendamustine as a bridge to CAR-T therapy. That confused me as previously I'd always thought neither Bispecifics or CAR-T were funded by the NHS for follicular lymphoma. I was aware though of a NICE document from 7th June 2023 "Axicabtagene Ciloleucel for treating relapsed or refractory follicular lymphoma", which contains the recommendation: "Axicabtagene Ciloleucel is not recommended, within its marketing authorisation, for treating relapsed or refractory follicular lymphoma after 3 or more systemic treatments in adults." Axicabtagene Ciloleucel is a CAR-T therapy.

It would perhaps be more helpful to say what it is recommended for! Anyway, I'm investigating further, I need to get to the bottom of this. I have a doctor cousin who used to sit on his local 'exceptional treatment panel' which is very helpful and I'm realising there are grey areas in all of this rather than the black & white you might expect. And that's without getting into trials and compassionate use schemes etc.

The photo is nothing to do with any of this, just a shot which I was pleased with of a small but rather stylish new housing development near Harrogate.