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blood cancers represent 10 per cent of all cancer cases in canada and affect people of all ages. it is the third leading cause of cancer-related deaths in canada. car t-cell therapies have changed the treatment paradigm for the management of patients with blood cancers, most notably aggressive b-cell lymphoma and acute lymphoblastic leukemia (all). this new standard of care offers renewed hope to those who have exhausted conventional therapies, and a chance for long-term survival.
clinical trials and real world experiences alike have proven the remarkable potential of car t-cell therapy, demonstrating its ability not only to yield durable remissions but, in some cases, to effect complete responses for patients with relapsed or refractory disease. however, implementation and accessibility pose formidable challenges in a healthcare system riddled with frustrating delays in the approval process, bureaucratic obstacles, and limited patient access (see “car t-cell therapy: a canadian timeline,” below). these delays thrust patients into a state of uncertainty, while the urgency of cancer demands swift action in delivering life-saving treatments. as car-t expands into different indications (like multiple myeloma) and in earlier lines of treatment, providing more people living with cancer more hope, the challenge of providing access to patients will get even more complex.
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tisagenlecleucel (kymriah)
pediatric and young adult patients up to and including 25 years of age with b-cell acute lymphoblastic leukemia (all) who are r/r (relapsed or refractory) after allogeneic stem cell transplant (sct) or are otherwise ineligible for sct, or have experienced second or later relapse. (pall) and adult patients with r/r large b-cell lymphoma after two or more lines of systemic therapy including diffuse large b-cell lymphoma (dlbcl) not otherwise specified, high grade b-cell lymphoma and dlbcl arising from follicular lymphoma
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axicabtagÈne ciloleucel (yescarta) the treatment of adult patients with r/r large b cell lymphoma (lbcl) after two or more lines of systemic therapy, including dlbcl not otherwise specified, primary mediastinal large b-cell lymphoma (pmbcl), hgbl, and dlbcl arising from follicular lymphoma
idecabtagene vicleucel (abecma) for adults with multiple myeloma who have received at least 3 prior therapies, including an immunomodulatory agent, a proteasome inhibitor, and an anti-cd38 antibody, and who are refractory to their last treatment
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brexucabtagene ciloleucel (tecartus) the treatment of adult patients with r/r mantle cell lymphoma (mcl) after two or more lines of systemic therapy including a bruton’s tyrosine kinase (btk) inhibitor.
lisocabtagÈne maraleucel (breyanzi) r/r large b-cell lymphoma after two or more lines of systemic therapy, including diffuse large b-cell lymphoma (dlbcl) not otherwise specified, primary mediastinal large b-cell lymphoma (pmbcl), high grade b-cell lymphoma, and dlbcl arising from follicular lymphoma
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tisangenlecleucel (kymriah) for the treatment of adult patients with relapsed or refractory grade 1, 2, or 3a follicular lymphoma (fl) after two or more lines of systemic therapy
axicabtagÈne ciloleucel (yescarta) the treatment of adult patients with r/r grade 1, 2 or 3a follicular lymphoma (fl) after two or more lines of systemic therapy
axicabtagÈne ciloleucel (yescarta) the treatment of adult patients with diffuse large b-cell lymphoma (dlbcl) or high-grade bcell lymphoma (hgbl) that is refractory to first-line chemoimmunotherapy or that relapses within 12 months of first-line chemoimmunotherapy.
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ciltacabtagene autoleucel (carvktyi) r/r multiple myeloma
brexucabatagene ciloleucel (tecartus) treatment of adult patients with r/r b-cell precursor acute lymphoblastic leukemia (all).