Faced with cancer, how much money would you give up on treatment? 100,000? 500000? 1000000? Shandong University’s aging science team once did a study and found that 10% of cancer patients had to give up some treatments in tears because of lack of money, and up to 52% of cancer patients had financial crisis. Since last June, the CAR-T product with a price of up to 1.2 million yuan, Akilense injection, has been launched, and many people on the Internet have said that it cannot be used. At present, the drug has not been covered by medical insurance, and is still a Purely self-funded anti-cancer drugs, but there are still many people who have paid for expensive treatment fees, more than 100.
The lesions disappeared within 1 or 30 days, and the first case of “1.2 million anticancer drugs” in Anhui was successfully treated. Recently, according to Xinan Evening News reported that seven years ago, Aunt Su (pseudonym) from Bengbu, Anhui, underwent bilateral ovary and hysterectomy due to ovarian mass. The postoperative pathological results showed diffuse large B-cell lymphoma. In the few years after the diagnosis, Aunt Su went to many hospitals for treatment, but the results were not satisfactory, and her condition kept recurring.
In February this year, Aunt Su was hospitalized again for treatment. When she was admitted to the hospital, Aunt Su had obvious swelling and pain in her face, and there was an obvious mass on the left side of her face. She had difficulty breathing and could not lie down and rest normally. . Considering that Auntie Su had performed a number of comprehensive treatments, the results were not satisfactory, and the expert team decided to perform CAR-T cell therapy for Auntie Su.
Only 10 days after the injection, the mass on Aunt Su’s face gradually disappeared. After one month, the PET-CT showed complete remission of the disease (all target lesions disappeared, no new lesions appeared, and tumor markers normal, for at least 4 weeks), Aunt Su’s life gradually returned to normal.
Aunt Su cured her cancer with “one injection” on the premise that she was not healed for many years? What is the best way to cure it?
Second, one shot kills cancer cells, what is the legendary “CAR-T” therapy?
CAR-T therapy is currently the most popular immunotherapy, which refers to the use of in vitro genetic engineering to modify patients’ peripheral blood T cells to transform T cells >, so that it has the characteristics of recognizing tumor cell surface antigens, and after in vitro diffusion culture, it is returned to the patient’s body, so as to kill cancer cells.
At present, in addition to 1.2 million yuan of Akilence injection, there are 7 main products on the market, they are:
1. Kymirah: 475,000 US$
for the treatment of follicular lymphoma, with an overall response rate of 86.2% and a complete response rate of 69.1%.
2, Carvykti (Sidakis Orensai injection): 2.93 million yuan
for the treatment of multiple myeloma, with a total response rate of 98% and a complete response rate of 78%
3. Abecma: US$437,900
For the treatment of multiple myeloma, the overall response rate is 72%, the complete response rate is 28%
4. Breyanzi : US$410,300
for the treatment of large B-cell lymphoma, with an overall response rate of 73% and a complete response rate of 54%
5. Tecartus: US$393,000
For the treatment of relapsed or refractory mantle cell lymphoma, with an overall response rate of 93% and a complete response rate of 67%< /p>
6. Yescarta: US$373,000
For the treatment of large B-cell lymphoma, the overall response rate is 83%, and the complete response rate is 65%
p>
7. Relma-cel (Ruiji Orenza injection): 1.29 million yuan
for the treatment of large B-cell lymphoma, with a total response rate of 75.9 %, the complete remission rate is 51.7%
Have you found that the above products are basically for the treatment of hematological tumors, and there is no solid tumor? This is the difficulty in the development of CAR-T therapy. Compared with “niche” blood tumors, solid tumors are the bulk of cancer treatment.
3. Further reading: Attacking solid tumors, Chinese experts upgrade “CAR-T” therapy
< One of the biggest difficulties of p>CAT-T for solid tumors is the lack of effective targets. The antigens of solid tumors are also expressed in normal tissues, which has a great off-target risk, making it difficult to guarantee the safety of CAR-T therapy. Solid tumors account for 90% of all tumors in the clinic. Currently, there is no CAR-T product targeting solid tumors on the market. On May 9, Shen Lin, Vice President of Peking University Cancer Hospital and her collaborators announced the results of a clinical trial showing a new type of therapy – CLDN18. 2Specific CAR-T cell therapy has great potential in digestive tract tumors.
A total of 37 cancer patients were selected for this study, including 28 patients with gastric cancer/esophagogastric junction adenocarcinoma and 5 patients with pancreatic cancer. All of these patients had high expression of CLDN18.2 protein. After the first injection of CAR-T cells into these patients, the observed safety was acceptable, with the overall response rate of the treated patients reached 48.6% and the disease control rate of 73%, respectively in gastric cancer patients. 57.1% and 75%.
Although CAR-T therapy is a “life-saving straw” for some cancer patients, many patients are faced with the dilemma of being suitable but unable to treat such “high-priced” drugs. , why the countryStill not including CAR-T products in medical insurance? Let the common people have medicines and can afford medicines at the same time?
Fourth, why can’t such expensive CAR-T products be covered by medical insurance?
The reason why sky-high anti-cancer drugs cannot be covered by medical insurance is very realistic, and it is also too expensive! Zheng Jie, head of the National Medical Insurance DRG Payment Technical Guidance Team responded that the price of anticancer drugs as high as 1.2 million yuan is far beyond the affordability of the medical insurance fund and the burden of the common people, and is not economical.
In the final analysis, one word: expensive! Why is CAR-T therapy so expensive?
1. Many raw materials rely on imports
my country’s CAR-T products are not highly differentiated, and many key equipment, reagents, and raw materials rely on imports. These costs are very high.
2. Private one-to-one customization
CAR-T therapy is a highly personalized therapy that can only be “customized” one-to-one , cannot be mass-produced. The production cost is very high. According to the data published by Shanxi Securities Research Report, the total cost of CAR-T products produced by the current production process ranges from US$150,000 to US$300,000 .
The advent of CAR-T products has undoubtedly brought new hope to many patients, but the high cost has also discouraged many patients. It is also hoped that the country can develop products with wider application and more affordable prices as soon as possible to change the plight of cancer patients.
References:
[1]Xu Guangxian.Research progress of CAR-T cell immunotherapy in tumor treatment[J].Journal of Guangdong Medical University,2022,40(02) :121-131.
[2]Mingzhu Su, Jiahui Lao, et.al.Financial Hardship in Chinese Cancer Survivors.Cancer.Published online Month 00, 2020 in Wiley Online Library.DOI: 10.1002/cncr .32943
[3]One million injections of CAR-T therapy: where is the price? Can you lower the price? What about solid tumors? The Paper The National Medical Insurance Bureau responded. Guangming.2021.12.4
[5] Destroy tumors with your own cells! Anhui’s first beneficiary completed treatment in the First Affiliated Hospital of China University of Science and Technology. Anhui Net.2022.5.2