(Adnkronos) - "L’ingresso di questi nuovi trattamenti” Ca-T “nell’ambito del trattamento dei linfomi ha stravolto le prospettive terapeutiche per una quota consistente di pazienti. I nuovi casi di linfoma in Italia sono più di 14mila ogni anno e la prima linea di trattamento guarisce oltre il 50% di pazienti. La rivoluzione sta proprio per quel gruppo di pazienti per cui invece avevamo delle prospettive terapeutiche estremamente limitate, con una quasi assenza di probabilità di guarigione. Oggi, grazie ai nuovi trattamenti, riescono a ottenere dei risultati sicuramente stupefacenti”. Così Armando Santoro, direttore del Cancer center e responsabile dell’Unità operativa di Oncologia medica ed Ematologia dell’Irccs Humanitas research hospital di Rozzano-Milano, commenta il via libera di Aifa alla rimborsabilità di lisocabtagene maraleucel (liso-cel) nei pazienti adulti con linfoma diffuso a grandi cellule B o con linfoma primitivo del mediastino a grandi cellule B oppure ancora con linfoma follicolare di grado 3B in recidiva o refrattari al trattamento dopo due o più linee di terapia sistemica. L’annuncio della rimborsabilità, a cui si somma anche quello di idecabtagene vicleucel (ide-cel) nel trattamento del mieloma multiplo, è stato dato da Bristol Myers Squibb in una conferenza stampa a Roma.
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00:00The introduction of these new treatments in the field of lymphoma treatment has changed
00:11the therapeutic prospects for a consistent quota of patients.
00:17Let us remember that the new cases of lymphoma in Italy are every year more than 14,000.
00:23The results with the first line of treatment are particularly good.
00:28We treat more than 50% of patients,
00:31but in the field of the most aggressive group of these lymphomas,
00:35which are the large B-cell lymphomas, the primitive lymphoma of the mediastinum
00:39and the follicular lymphomas of grade 3,
00:42when there is no cure with the first treatment,
00:47there is an extremely compromised situation of prognosis
00:51with only a small percentage of patients who manage to obtain the cure.
00:57The revolution is precisely in this group of patients
01:00for whom we had extremely limited therapeutic prospects
01:06with an almost absence of probability of cure,
01:10today they manage to obtain certainly amazing results.
01:15If we look at the study, for example,
01:18the study TRASHEND, which was done with the isocell,
01:23we can see how the percentage of complete and partial remissions
01:30rises by 75%, but above all,
01:33there are more than 50% of patients who obtain a complete remission.
01:38Many of these complete remissions remain permanent,
01:43thus giving the idea of a definitive cure.
01:46Another significant advantage of this type of CAR-T
01:52is represented by the profile of toxicity.
01:55CAR-T often has significant side effects
01:58in terms of two syndromes, two strange diseases,
02:02the syndrome of release of cytokines,
02:04a neurological toxicity defined by ICANTS.
02:07Well, with this molecule, with the isocell,
02:12the toxicity is clearly reduced
02:19compared to the other CAR-T available.
02:21Lymphoma, I think we have already said it,
02:24roughly there are 2,500-3,000 patients a year
02:27who can possibly access CAR-T.
02:31I repeat, there are not only lymphomas with large B cells,
02:34but there are also other variants of lymphomas.
02:36As far as myeloma is concerned, the number of myeloma is lower.
02:40Overall, in Italy there are around 4,500-5,000 new cases,
02:45but we consider that it is an increasing pathology,
02:48therefore an increasing incidence.
02:50We also consider that myeloma in general is not a curable disease,
02:54so almost all patients are destined to receive
03:00a second, third and even fourth line treatment.
03:03So I'm not saying it's the whole population,
03:06but it's a very high percentage.
03:08The limits for myeloma to reach CAR-T
03:11are mainly represented by contraindications to treatment,
03:15because myeloma is a disease that mainly affects the elderly,
03:20so there could be a significant number of these patients
03:23who are not eligible for CAR-T,
03:25but I still believe that absolutely more than 50% of patients,
03:29perhaps 70%, can be eligible for CAR-T.