NHS treats first adult B-cell leukaemia patient with CAR-T immunotherapy

A patient with B-cell acute lymphoblastic leukaemia (B-ALL) has become the first adult to receive a pioneering cell therapy on the NHS.

The chimeric antigen receptor T cell (CAR-T) therapy, known as obe-cel (obecabtagene autoleukel), was administered at Manchester Royal Infirmary following a decision by NHS England to make obe-cel available for eligible adult patients with relapsed or refractory B-ALL. The therapy was developed by researchers at University College London (UCL) and UCL spin-out company Autolus Therapeutics.

'The first leukaemia patient to receive cutting-edge personalised immunotherapy is a life-changing moment for the family and a landmark for UK life sciences,' said Dr Anne Lane, CEO of UCL Business. 'This shows what the UK can achieve when world-class doctors and researchers work together, backed by strong innovation, infrastructure and patient investment.'

CAR-T therapy is a form of immunotherapy targeting cancer that involves collecting a patient's own T-cells (white blood cells). These are then edited 'ex-vivo' in a laboratory, using a lentiviral vector to deliver the CAR transgene, to be more effective at recognising and attacking cancer cells. The edited cells are then reintroduced into the patient by injection (see BioNews 1231, 1195, 1172, 1131 and 904).

While first-generation CAR-T therapies are already in use, obe-cel is designed to be safer and more effective for adults. It features a unique 'fast-off' mechanism, where the engineered T-cells bind to cancer cells long enough to kill them before quickly releasing, which reduces the risk of severe side effects such as cytokine release syndrome and neurological toxicity.

Clinical trial data suggest that obe-cel can induce high remission rates in patients with advanced B-ALL. In a phase I/II study, over half of the participants achieved complete remission, with many remaining cancer-free at follow-up. Importantly, rates of severe side effects appeared lower than those reported for earlier CAR-T therapies, although longer-term monitoring is ongoing.

'Usually, this type of leukaemia is very aggressive, and adult patients don’t live beyond six to eight months. With this therapy, we are able to offer them years and potentially a cure,' said Dr Eleni Tholouli, the patient's haematologist at Manchester Royal Infirmary. 'It's very significant and is revolutionising the way we tackle this cancer.'

CAR-T therapy has been available on the NHS since 2019 to treat B‑ALL in children and young adults (up to age 25). However, obe-cel is the first CAR-T therapy to be approved for adults with B-ALL, a group that has previously had more limited treatment options once standard therapies fail, and reflects wider efforts to expand access to personalised cancer treatments within routine NHS care.

Researchers hope that this therapy will eventually be rolled out to more specialised centres across the country. Ongoing studies will use real-world data from NHS patients receiving the treatment to assess its long term safety and durability of response.