2024-05-13
Milestone celebrated Monday the 13th of May, 2024 at Uppsala Castle
On May 13th, 2014, the first chimeric antigen receptor (CAR) T cell treatment in Europe was administered to a lymphoma patient as part of a clinical trial at Uppsala University Hospital (EudraCT No: 2013-001393-19). The trial was a collaboration between Uppsala University, Uppsala University Hospital and Baylor College of Medicine in Houston, Texas. 15 patients were treated in the first study, that was soon followed by a second study with the same CD19-targeting CAR T cell product at Uppsala University Hospital in 2017. 10 years to the day, this milestone was celebrated with a program reflecting on the first treatment and developments over the last 10 years.
First infusion of European CAR T
CAR T cells is an immunotherapy that uses the ability of a patient’s own immune system, or more specifically T cells, to recognize and kill endogenous cells that have become infected with viruses or transformed into tumour cells. The medicine is produced by patient donating a slightly larger blood sample from which T cells are purified. These cells are then genetically modified to express a new protein on the cell surface – called a chimeric antigen receptor (CAR). This receptor consists of an antibody part (which recognizes the tumour) and parts of the T cell receptor (the receptor by which T cells normally recognize their targets). The cells are then given back to the patient where they seek out the tumor cells in the patient’s body and kill them.
At Uppsala Castle, Monday the 13th of May, Hannah Karlsson, Margareta Kvitz, Angelica Loskog, Hans Hagberg, and Gunilla Enblad (pictured left to right) shared their experiences from involvement in the first treatment. A patient that has received CAR T cell treatment also spoke about their experience. Gunilla and Magnus Essand continued by presenting the exciting CAR T activities in Uppsala now and to come.
CAR T cells have paved way for ATMPs in Sweden and helped establish logistics and infrastructure relevant for autologous cell therapies. A therapy initially approved to treat blood cancers (lymphoma and leukemia), that has more recently been shown effective in clinical trials of patients with myeloma and inflammatory diseases such as MS and SLE.
Since 2014, six drugs of this type have been approved for treatment in the US (FDA) and Europe (EMA), three of which are recommended by the NT Council and available for treatment in Sweden. A large number of clinical trials are ongoing worldwide with different variants of CAR T cells, to ensure efficacy and safety before they are given to patients in clinical routine. One of these, CARMA (EudraCT No: 2022-004157-31), has just started enrollment at Uppsala University Hospital to treat lymphoma patients with a completely new type of CAR T cell treatment – CAR20(NAP), developed at Uppsala University.
Milestones for CAR T cell therapy
2010 First adult patient treated in the world at the University of Pennsylvania, USA.
2012 First child in the world treated, a then five-year-old girl, who responded well and is still alive. The family has started The Emily Whitehead Foundation to support cancer research.
In 2013, Science magazine recognized the importance of immunotherapy by naming it the Breakthrough of the Year.
13 May 2014 The first adult patient in Europe was treated at the Akademiska Hospital in Uppsala.
It was approved by FDA aug 2017, EMA in aug 2018 and recommended by the NT council in may 2019. I.e. from the approval in the US it took almost two years for us to get it in Sweden.
May 2019 The CAR T cell therapy Kymriah was recommended for use by the Swedish NT council (under the orderly introduction procedure). As the first CAR T cell product in the world, it was approved for use by the FDA in August 2017 and a year later in August 2018 by the EMA.
2019 SWECARNET (”Sweden’s CAR T Cell Competence Network”) is formed
2021/2022 Reports are published on patients with the autoimmune disease lupus (SLE) treated with good results with CAR T cells.
2024 Clinical studies initiated with CAR T cells for the treatment of SLE and MS respectively.
Today (May 2024), six CAR T-cell therapies are approved by the FDA and EMA; Kymriah, Yescarta, Tecartus, Abecma, Breyanzi and Carvykti. Of these, three are recommended by the NT Council for use in Sweden; Kymriah, Yescarta and Tecartus.