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Cancer patient is first in Wales to get gene treatment

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Cancer patient is first in Wales to get gene treatment

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Media caption "I'm unlucky to have to, but I'm lucky to be approved by the panel," says John Davies

One patient became the first in Wales to initiate a revolutionary new genetic treatment for blood cancer.

CAR-T therapy involves the genetic modification of one type of body immune cells in the hope that they will recognize and destroy cancer cells.

John Davies, 71, of Blackwood, will have his blood frozen in Amsterdam and then modified in the United States before being transfused next month.

Despite chemotherapy for several years, John's lymphoma was not cured.

This is the first time in Wales that treatment has been offered after approval of NHS use last year.

The exact cost of treatment is commercially sensitive, but it is believed to be around a third of a million pounds.

In Wales, it is being funded by the Wales Specialized Health Services Committee through the New Treatment Fund created by the Welsh government in 2017.

In England, CAR-T therapy is being funded through the cancer drug fund.

This form of immunotherapy is a real-world example of precision medicine as it needs to be developed for every patient.

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John says, "I hope for the worst and hope for the best."

Retired civil servant John found that he had non-Hodgkin's lymphoma five years ago when he went to do a routine checkup.

He had numerous unsuccessful treatments before CAR-T therapy became available.

"It's not automatic – I'm unlucky enough, but I'm lucky to be approved by the panel," he said.

"I'm a little pioneer, I hope this helps those behind me – it may not work for me, so I expect the worst and hope for the best."

What will happen to John's blood?

Parts of the immune system – white blood cells called T cells – were removed from John's blood at Wales University Hospital in Cardiff on Monday.

Later that afternoon they were mailed to Amsterdam and frozen in liquid nitrogen before being transported to a laboratory in California.

There, the white blood cells will be genetically reprogrammed so that instead of killing bacteria and viruses, they search for and destroy cancer cells.

They are now "chimeric antigen receptor T cells" – or CAR-T cells.

The cells will be multiplied before being returned to Cardiff and returned to John within a month.

John will need to be carefully monitored for a period in the hospital for potentially dangerous side effects after receiving the modified cells.

We will follow John's progress in the coming months.

This is a new therapy and very long term data are still being generated, but clinical trials showed that 40% of patients had all signs of untreatable terminal lymphoma eliminated from the body 15 months after treatment.

It was approved by the National Institute of Excellence in Health and Care for NHS use in 2018 for specific patients for whom other forms of treatment were unsuccessful.

Cardiff is the ninth place in the UK to offer treatment – one of 13 specialist centers expected to be able to offer it.

About 130 patients in the UK have received CAR-T therapy so far in 2019.

Funding must be approved on a case by case basis and there will be an assessment of its cost-effectiveness.

Keith Wilson, clinical director of the Wales Blood and Marrow Transplant Program, said: "This is the best personalized medicine. It is personalized, patient-tailored and unique to that particular patient.

"He has to donate his own cells, they are adapted to match his and his cancer, and when we give them back to him within a month, those cells will do what the immune system normally does – fight the infection. Except in In this case, they were led to think that cancer is an infection. "

John said he was very grateful.

"I paid my tax … for 40 years, but I think I'm late now, after all the wonderful treatment."

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