People with an aggressive form of blood cancer have been given fresh hope as two new drugs are set to be rolled out on the NHS.
The medications, epcoritamab and loncastuximab tesirine, were approved by the NHS’s spending watchdog within two days of one another, throwing a lifeline to patients living with a type of non-Hodgkin’s lymphoma that kills four in ten within five years of diagnosis.
Every year about 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, don’t work properly and build up in the lymph nodes or other parts of the body. It commonly shows up 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 either 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, don’t work properly and build up in the lymph nodes or other parts of the body (stock photo)
Epcoritamab, sold under the brand name Tepkinly, is given via monthly injections. It’s what’s known as a bispecific antibody – a protein that recognises and attaches to cancer cells, helping the body fight off the disease
Loncastuximab tesirine, however, is an antibody-drug conjugate, which is given via a drip and works by seeking out proteins on the surface of cancer cells and delivering chemotherapy to the tumour to kill them
Epcoritamab, sold under the brand name Tepkinly, is given via monthly injections. It’s what’s known as a bispecific antibody – a protein that recognises and attaches to cancer cells, helping the body fight off the disease.
One study showed that 39 per cent of patients given the treatment were cancer-free after just ten months.
Loncastuximab tesirine, however, is an antibody-drug conjugate, which is given via a drip and works by seeking out proteins on the surface of cancer cells and delivering chemotherapy to the tumour to kill them.
Dr Dima El-Sharkawi, a consultant haematologist at London’s Royal Marsden NHS Foundation Trust, 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, often dying within months. The standard treatment for DLBCL is known as R-CHOP – a combination of chemotherapy and an immune-boosting cancer treatment called immunotherapy that trains the body to ward off cancer.
This currently cures about half of DLBCL patients, but the remaining sufferers have to seek alternative options such as a stem cell transplant – formerly known as a bone marrow transplant.
This procedure involves stem cells from the patient or a donor being harvested from their bone marrow – the spongy tissue inside our bones responsible for making red blood cells and immune system white blood cells.
These are multiplied in a lab before being injected into the patient in the hope they stop the body from producing the faulty white blood cells that characterise blood cancers such as DLBCL.
More recently, patients have been offered CAR-T therapy, which modifies cells in the immune system to target and attack cancer cells.
However, some people are too frail to cope with its side effects – which can include breathing troubles, fever, low blood pressure and vomiting – and around half of patients who opt for the treatment see their cancer come back.
Dr El-Sharkawi says: ‘There’s been an explosion in terms of treatment options for DLBCL. All you need for each patient is for just one of these drugs to work.’
Alexander Gudmestad, 34, was first given his ‘devastating’ DLBCL diagnosis in spring 2020 in his native Norway after he discovered several lumps on 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 didn’t stop growing. I’d had testicular cancer when I was a kid, so I knew to go to the GP quickly.’
Alexander’s doctors in Norway started treating him with R-CHOP to an 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 on returning.
In 2022, Alexander moved to England and underwent CAR-T therapy on the NHS at the Royal Marsden Hospital NHS Trust. The cancer returned later that year and Alexander started 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 ‘really good news’ that the treatment is working, and that Alexander is now cancer-free.
‘I’m very happy that it’s working and I’ll be continuing with the treatment for as long as it does work,’ he adds. ‘I can live fairly normally with the disease and the treatment for as long as it works, which wasn’t an option before.
‘If I was in the same situation two years ago there would have been no hope.’