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home / blood cancer / opinion: canada’s cancer care system is running out the clock on patients

opinion: canada’s cancer care system is running out the clock on patients

if we are serious about transforming cancer care, then we must stop applauding innovation while leaving patients to wait in limbo.

by sabrina hanna, bsc.
published jun 02, 2025
read time 3 minute read
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read time 3 minute read
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ontario recently announced an accelerated access initiative for life-saving therapies, a promising signal of intent. but even the best provincial efforts cannot compensate for a system that remains fragmented, slow, and bureaucratic. getty images
on june 3, 2025, long-term data from the cartitude-1 trial will be presented at the american society of clinical oncology (asco) annual meeting. the results continue to confirm how chimeric antigen receptor t-cell therapy (car-t) continues to transform the landscape of blood cancer treatment.
this latest update focuses on patients with relapsed or refractory multiple myeloma (mm)—individuals for whom no other treatment options remain. a single infusion of ciltacabtagene autoleucel (cilta-cel), a car t-cell therapy, delivered outcomes that were once unimaginable. with more than five years of follow-up, median progression-free survival reached nearly three years. some patients remain in remission today—five years later. for a population with an expected survival of less than one year, these results are not just promising. they are transformative.
and this is not an outlier. car t-cell therapy has produced similarly groundbreaking outcomes in other hematologic malignancies, including aggressive lymphomas and leukemias. in pediatric patients with relapsed b-cell acute lymphoblastic leukemia, car t has enabled long-term remission where no options once existed. in adults with diffuse large b-cell lymphoma, it has extended survival even in late-stage disease.

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opinion: car t-cell therapy delays jeopardize lives of canadians with blood cancer
we call for a multi-stakeholder approach that includes government, regulatory and reimbursement bodies, the pharmaceutical industry, clinician and patient leaders to develop solutions that address both healthcare system challenges and the plight of patients who cannot afford to wait.
access to car t-cell therapy is a challenge in a healthcare system riddled with frustrating delays in the approval process, bureaucratic obstacles, and limited patient access.

car t-cell therapy is here and it's reshaping the future of precision cancer treatment
while awareness of car t-cell therapy has grown since its introduction to blood cancer treatment in 2018, there’s still a perception that the approach is more far-off science fiction than happening in cancer clinics around the world.
patients have to meet eligibility criteria for car t-cell therapy, which usually includes receiving chemotherapy and an autologous stem cell transplant. if these have failed, then car t can be considered.
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but in canada, that possibility remains out of reach for many.
despite health canada approval and a positive recommendation from cadth (now the canadian drug agency-cda) in november 2023, cilta-cel remains stalled at the pan-canadian pharmaceutical alliance (pcpa), where it has been under review since november 10, 2023. no public timeline exists for when that will change.
these delays are not about uncertainty—the evidence is clear.
ontario recently announced an accelerated access initiative for life-saving therapies, a promising signal of intent. but even the best provincial efforts cannot compensate for a system that remains fragmented, slow, and bureaucratic. there is no ‘accelerated access’ when the processes’ that make treatment accessible are stuck in neutral, despite our best efforts.
these delays aren’t just costly to patients, but to health systems as well. a 2022 study published in the american journal of managed care found that delays to car t-cell treatment significantly reduce its clinical effectiveness, economic efficiency, and societal value. as patients deteriorate while waiting, they become less likely to benefit from the therapy. the longer the delay, the smaller the gains—in both health outcomes and long-term cost savings. in short: we are squandering value while patients run out of time.
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canada is rapidly falling behind in delivering cell and gene therapies. the infrastructure to manufacture and administer these therapies is insufficient. our approval processes are sluggish. funding decisions lag behind scientific consensus. and our inability to act quickly is driving a growing gap between what is medically possible and what is systemically permitted. this is not a failure of innovation. it is a failure of implementation. this is not a failure of science. it is a failure of systems.
and the cost is measured in more than missed opportunities. it is measured in lives.
if we are serious about transforming cancer care, then we must stop applauding innovation while leaving patients to wait in limbo. the only thing standing between canadians and this therapy is the system that claims to serve them. in cancer care, timing isn’t everything—it’s the only thing. and right now, canada is running out the clock.
sabrina hanna, bsc. is the chief change officer of the cancer collaborative, a patient-driven think tank dedicated to bridging science, policy and advocacy, to accelerating policy change and contributing to a more reflective and informed decision-making process in cancer care.

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