Paul (pseudonym), 31, had the misfortune of suffering from recurrent and incurable diffuse large B-cell lymphoma (DLB-CL). After chemotherapy twice, an infection and viral myocarditis (VMC) developed to threaten his life. Recently, he received the latest marketed domestic chimeric antigen receptor T (CAR-T) cell immunotherapy at Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology. At present, his tumor is in complete remission in his body, which is the first time that China's domestic CAR-T cell immunotherapy has been applied clinically. It is reported that this treatment costs RMB 1.2 million, only 40% of the price abroad. In the future, the cost of domestic CAR-T cell immunotherapy is expected to be further reduced.

The Unlucky Guy Lucky to Use New Domestic CAR-T Drug

In April 2021, Paul was diagnosed with double-hit DLB-CL after a physical examination revealed enlarged abdominal lymph nodes. For him, in his prime, it was like a bolt from the blue.

DLB-CL is a malignant blood tumor with a cure rate of nearly 60% for the normal type, but the double-hit type on Paul has an exponential increase in tumor cell malignancy due to gene rearrangements, difficult remission and rapid recurrence, with a 5-year survival rate of less than 20%.

Paul began to receive his chemotherapy disturbed. After the 2nd chemotherapy, he had a fever due to infection and VMC; his myocardial enzymes rose to over 10000 and his white blood cell count was extremely low, and he was given a critically ill notice. Considering that continued treatment could lead to multi-organ damage and hasten death, the doctors had to forgo the full dose of chemotherapy.

Though bitterly disappointed, Paul didn’t give up. After seeking the best therapy all over the country, he found Prof. Zhou Jianfeng, a hematologist and oncologist who specializes in CAR-T cell immunotherapy working at Tongji Hospital. After carefully reading all of Paul's medical records, Prof. Zhou affirmed to him that he was 80% confident to save him: "Double-hit lymphoma can rarely be cured with chemotherapy, and even with hematopoietic stem cell transplantation, the long-term remission rate is low; you're not too late and haven't missed the best time for treatment."

On September 3, China's first Class 1 new biological drug CAR-T product, Relma-cel was officially approved for clinical use. Lucky Paul had the chance to use the new drug and on the day it was launched, Prof. Zhou wrote the first prescription for him in the country.

Five days later, Paul underwent T-lymphocyte collection at Tongji Hospital. Doctors then separated, extracted, and made T-lymphocytes in vitro into super soldiers "CAR-T cells”, which can target tumors. While waiting for the cells to be transfused back into his body, the tumor in his body recurred and his condition turned critical.

On October 3, Paul finally got his CAR-T cell transfused back. Soon CAR-T cells were activated in Paul's body and proliferated to attack and kill the diseased leukocytes and other tumor cells as if they were equipped with a GPS.

After close monitoring and careful treatment, postoperatively, Paul did not develop cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. He completed his treatment very safely and successfully. Recently, Paul returned to Tongji Hospital for a follow-up examination and PET-CT showed that his tumor was in complete remission.

"For patients with relapsed and refractory hematological tumors, CAR-T cell immunotherapy is a powerful life-saving remedy," delightedly said Prof. Zhou, who won the unexpected success. 

Only 40% of the Price Abroad

Cell Therapy Expected to Be Popular in China

CAR-T cell immunotherapy is a targeted therapy technology for tumor cells. In August 2017, the world's first CAR-T cell immunotherapy developed by Novartis U.S. was approved for the treatment of patients with precursor B-cell lymphoblastic leukemia. During the same period, Chinese doctors, represented by Prof. Zhou Jianfeng's team, were also actively conducting clinical trials.

In June 2021, the CAR-T product Axicabtagene Ciloleucel, introduced from the United States, was launched in China. In September, Zhou Jianfeng's team quickly introduced it into clinical application and successfully achieved remission in a patient with refractory lymphoma complicated with P53 mutation, the first case in central south China.

Three months after the introduction, on September 3, a CAR-T product independently developed by China quietly came on the market, ushering in a more affordable cell therapy for Chinese tumor patients. Compared to Novartis’ sky-high price of $475,000, domestic CAR-T costs only 40% of that price.

From clinical trials to the market, Zhou Jianfeng's team is running at the forefront of medical treatment. Back then in 2015, Prof. Zhou Jianfeng's team completed the first case of ultimate CAR-T treatment for leukemia in central China.

"This is a new weapon for oncologists or hematologists, and one day when it is introduced to clinical application, the patient has one more chance of survival," Zhou Jianfeng said, based on a report on the phase III clinical results of domestic CAR-T, which he believes is safer compared to that sold in foreign countries and is actively promoting. "In the future, as the technology continues to mature and become more popular, patients may only have to go through a short course of chemotherapy before they can enter cell therapy and return to normal life sooner. Of course, the fulfillment of these aspirations and expectations needs to be validated in clinical trials and supported by evidence."

It is reported that CAR-T cell immunotherapy has been gradually applied worldwide in the treatment of leukemia, lymphoma, myeloma and other hematological tumors. To date, patients with hematological tumors from more than a dozen countries and regions have regained their lives in Tongji Hospital. At present, CAR-T clinical trials are extensively conducted in China, and patients can also receive free treatment through clinical trials, and the cost of treatment is expected to decrease as more and more CAR-T drugs are on the market and produced in a standardized and large-scale manner.