The Spanish Medicines Agency (Aemps) has recently approved a new CAR-T therapy, which is only the second public immunotherapy in the world for multiple myeloma, the second most common blood cancer behind chronic lymphatic leukaemia. 

This is a type of cancer that forms in certain white blood cells called plasma cells.  

The new CAR-T therapy has been manufactured entirely by Hospital Clínic in Barcelona. According to reports, there is no other hospital in the world that has manufactured a product of this type.  

CAR-Ts are a type of advanced immunotherapy, treating not only blood cancers, but tumours or diseases such as lupus or multiple sclerosis. It works by carrying out a genetic modification of the patient’s blood.  

The Aemps Committee for the Evaluation of Medicines for Human Use has given the green light for Hospital Clínic’s CAR-T ARI-0002 as an advanced therapy medicine in patients with multiple myeloma in a situation of relapse. This was announced this Friday at a press conference by the Barcelona hospital and the Department of Health. 

It now means that oncology departments across Spain will be able to use this type of therapy, without patients having to travel to Barcelona for treatment. 

Spain’s Health Ministry has also authorised the financing of another new immunotherapy treatment, designed to help fight a range of different types of cancers, mainly types of tumours.  

This will replace the current intravenous drip with a subcutaneous injection, reducing treatment time from one hour to seven minutes, without losing its effectiveness.

The injection, called atezolizumab, will be given to patients once every three weeks without need to remain in hospital for observation afterwards, meaning it’s not only easier for them, but it also saves health resources too.

Atezolizumab was authorised by the European Medicines Agency (EMA) last January and will be used treat the same nine conditions as the intravenous drug, mainly tumours of the lung, liver, bladder and breast.

It will also be used for some of the most aggressive and difficult-to-treat forms of cancer, such as early-stage non-small cell lung cancer or for various forms of metastatic cancer; hepatocellular carcinoma and alveolar soft-part sarcoma, among others. 

Immunotherapy treatments for cancer differ from chemotherapy in that it helps the body identify and attack cancer cells better using its own immune system. This means it can continue to work even when the treatment has ended.  

Chemotherapy on the other hand kills fast growing cells, which can be cancerous as well as non-cancerous.  

Both treatments are still used for different types of cancer and different patients or even in combination with each other. Chemotherapy can work more quickly for example, but immunotherapy can help over a longer period of time and is less invasive and damaging to the body.

According to the recent IMscin002 immunotherapy trail, the subcutaneous injection is preferred by 79 percent of patients, because they find it less invasive, painful and annoying, which results in a higher quality of life.  

Nine out of ten healthcare professionals agreed that the injection is easy to administer and three out of four said it could save time too.

The approval of the new drug in Spain’s public health system is based on data from the phase III IMscin001 trail, in which seven Spanish centres participated, totalling 20 percent of the number of patients recruited for it worldwide. This showed that the injection was found to be just as safe and efficient as the intravenous option.

Spain is a world leader in CAR-T research, an immunotherapy that has already treated more than 1,000 patients in the country and that has proven to be effective against certain types of cancer, such as breast cancer or glioblastoma of the brain, but especially haematological cancers, such as leukaemia or lymphoma.

This means that we can expect an increasing number of immunotherapies for cancer to be available through Spain’s public health system in the coming years.

For the treatment of large B-cell lymphoma, mantle cell lymphoma, multiple myeloma, and acute lymphoblastic leukaemia in adults, the following hospitals in Spain offer immunotherapy:

• Donostia University Hospital (Basque Country).
• University Hospital Complex of A Coruña (Galicia)
• Reina Sofia University Hospital (Andalusia).
• Regional University Hospital of Malaga (Andalusia).
• Central University Hospital Complex of Asturias (Asturias).
• Marquis of Valdecilla University Hospital (Cantabria).
• Virgen de la Arrixaca University Clinical Hospital (Murcia Region).
• Morales Meseguer University Clinical Hospital (Murcia Region).
• Son Espases University Hospital (Balearic Islands).
• Puerta del Hierro Hospital in Majadahonda (Community of Madrid).
• Ramon y Cajal University Hospital (Community of Madrid).
•  Hospital 12 de octubre (Community of Madrid).
• La Paz University Hospital (Community of Madrid).
• La Princesa University Hospital (Community of Madrid).
• Hospital Clínic de Barcelona (Catalonia)
• Sant Joan de Déu Hospital (Catalonia)

For the treatment of acute lymphoblastic leukaemia in paediatrics, the following hospitals in Spain offer treatment:

• University Hospital Complex of Santiago de Compostela (Galicia)
• Reina Sofia University Hospital (Andalusia)
• Regional University Hospital of Malaga (Andalusia)
• Virgen de la Arrixaca University Hospital (Murcia Region)
• Son Espases University Hospital (Balearic Islands)