EHA Topics in focus : Immunotherapy

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Published: 16 Jun 2018
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Prof John Gribben - Barts Cancer Institute, London, United Kingdom

Prof John Gribben speaks at EHA 23 about the development of a dedicated education programme for immunotherapy as a key topic, especially the current and future indications of CAR-T cells.

He outlines the difference in access and development of CAR-T therapies between the US and Europe, and the economic factors that may drive cost and clinical development of further research.

Prof Gribben emphasises the place of ongoing education for clinicians, patients and policy makers in understanding and influencing the course of development.

For more on this, watch his interview with ecancer.

I want to talk to you about our EHA Topics in Focus programme in immunotherapy, why we thought that immunotherapy was an issue that should be a topic in focus and of course what we mean by Topics in Focus.

Each year in the past, ASH… ASH?

I’ve done it again! EHA are going to kill me!

Stockholm, Sweden, thank you.

Each year EHA has had a focus of the meeting and this year the focus was immunotherapy.

Our issue about a topic of the year is that we have it, next year we have another topic, there’s no follow-on and no one even remembers what last year’s topic was.

The Topics in Focus programme is about setting up a programme to tackle issues that we think are of high priority.

One, of course, is going to be haemoglobinopathies that you’ve just heard about, the other is going to be immunotherapy. So let me take you through this.

So this is a new EHA programme that looks to tackle high impact issues faced by the medical world today, and I’ve already said immunotherapy.

This year we’re focussing on CAR-T cell therapy and in the haemoglobinopathies we’re focussing on sickle cell disease, because of course you’ve just heard it’s Sickle Cell Disease Day coming up.

But we believe that these topics go beyond those particular scopes and immunotherapy is more than just CAR-T cells.

We view that in Europe there’s an immediate need to get up to speed with where the USA is compared to Europe in terms of delivery and being able to deliver CAR-T cell therapy, but that the whole field of immunotherapy is going to revolutionise hematologic malignancies and therefore we’re broadening the topic out from just CAR-T cells.

We’re also aware, although it’s not my remit to talk about today, the haemoglobinopathies, is that sickle cell disease of course is very common but other haemoglobinopathies are increasingly important in Europe because of the migration issue, that we now have a different population and a different level of expertise available to treat those diseases.

So the programme’s goal, and it’s a programme, it’s not just this meeting, it’s not just going to be this year, it’s going to be a continuing programme that’s going to be supported by EHA with a whole variety of other partners, is to raise awareness, provide education, further research and build a network of experts with the goal of improving the patient care and, in this particular field, increasing access to the therapy, access through our lobbying strategies to lobby with EMA and Brussels to have funding available for these techniques, and access with centres of excellence able to deliver that care to our patients. 

Of course, through a lot of work that TON is doing, making these affordable at every level, in terms of the price, affordability and value in terms of what it is we’re trying to do.

So why immunotherapy?

Well clearly the field’s internal speed of change, frontline accomplishments in the medical field and of course the approval now of agents from two companies in a variety of different haematology malignancies has created an increasing need for adaption to new techniques and therapies, and in the first instance we’re focussing on CAR-T cells.

So in that setting we are looking to have, as part of this group, and we had of course our first session yesterday, our first workshop, but that workshop is the beginning of a programme that’s going to look at the training requirements: what’s required for a site to be able to deliver this type of therapy safely, where safety becomes the major priority; patient selection: who are the appropriate patients and, just as importantly for very expensive therapies, who are the not appropriate patients; planning for leukapheresis; the multidisciplinary approach of patient management, so the educational needs are not just of physicians but of scientists, healthcare professionals, our nursing colleagues, education from the centres that are going to deliver the therapy, but education back to the sites that have referred the patients and will then have to look after potential new complications arising later.

Thinking about bridging and lympho-depleting strategies, infusion site logistic safety, the long-term follow-up.

And, as already mentioned, a large part we’re doing through a whole variety of different approaches through different subcommittees that are all going to work together within this work-stream is thinking about access, reimbursement mechanisms and regulatory policy, all of which we believe that we as a large organisation can have a louder voice to be able to advocate on our behalf for these areas.

And also to provide information and have partnerships with the patient, patient groups, caregivers through education and consideration of quality of life issues.

So that, in a nutshell, is what the Topics in Focus on immunotherapy is meant to be about.

To remind you yet again, although we focussed this year, we focussed in the symposium yesterday, on CAR-T cells, this is going to include bispecific antibodies, BiTEs, monoclonal antibodies, checkpoint inhibition in combinations, so it’s a much broader scope than just CAR-T cells.