1.2 million injections of anticancer drugs, the first patient in Anhui was successfully treated! Is it worth it to eradicate the tumor in a month?
If the cancer has recurred many times after multiple treatments, would you still choose to continue the treatment? Aunt Su (pseudonym) from Bengbu, she made the choice to "continue treatment".
Auntie Su, 57, suffers from diffuse large B-cell lymphoma. Although she underwent bilateral uterine adnexectomy a few years ago, her condition has recurred several times with poor results . In February this year, under the recommendation of Professor Wang Xingbing, Department of Hematology, Department of Hematology, First Affiliated Hospital of China University of Science and Technology, Auntie Su tried a new therapy - CAR-T cell therapy . Auntie Su also became the first beneficiary in Anhui.
After careful preliminary preparations, on March 7, Auntie Su injected 68ml of CAR-T cell Akilence injection for the first time, and the infusion process went smoothly.
After 10 days of injection, the mass on Aunt Su's face gradually disappeared, and 30 days later, PET-CT showed that the condition had reached complete remission .
After the professional evaluation by the doctor, Aunt Su's condition has been completely relieved clinically, and after that, she only needs regular review and monitoring. At present, Aunt Su is gradually returning to her normal life.
Source: Anhui Net
What is CAR-T cell therapy?
This name may sound unfamiliar to everyone, but if you put it another way, you may have an impression - the treatment method of "1.2 million needles of anticancer drugs to clear cancer cells" . Is it really worth spending millions to treat cancer?
1. How effective is CAR-T cell therapy?
Maybe some people are skeptical about the claim of "clearing cancer cells". Putting aside the price, is the efficacy of this treatment really that good?
CAR-T is an engineered killer cell that specifically targets cancer cells. By artificially transforming T cells, they can activate their ability to eliminate tumors, and can also achieve precise killing, eliminating tumor cells without harming normal cells .
There are three main steps in cell therapy: collecting patient T cells → using genetic engineering to transform into CAR-T cells → returning CAR-T cells to the patient.
Can CAR-T really achieve "complete elimination of cancer cells"?
As a new type of precise targeted therapy, CAR-T cell therapy is the "star therapy" in immunotherapy, especially in the treatment of hematological malignancies .
In previous clinical trials of CAR-T therapy, the remission rates of leukemia and B-cell lymphoma have been greatly improved, with the remission rate of the former exceeding 90% and the latter exceeding 80%.
However, Professor Xu Pengpeng, deputy chief physician of the Department of Hematology of Shanghai Ruijin Hospital, said that "complete remission" in medicine refers to the disappearance of lesions after CT or PET-CT examination, but this does not mean "cure". It takes at least 5 years of "complete remission" before it can be considered a cure .
In fact, not everyone needs and is suitable for CAR-T therapy. For naïve patients, 60%-70% can be cured by first-line standard treatment.
At present, the applicable population of CAR-T therapy approved in China is: adult patients with relapsed or refractory large B-cell lymphoma who have received second-line or above systemic therapy in the past .
It can be seen that CAR-T cell therapy is not a panacea anti-cancer drug, and there are also risks. For example, patients with large masses are prone to cause tumor lysis syndrome, leading to adverse reactions such as related neurotoxic syndrome.
2. Why can't such an expensive therapy be covered by medical insurance?
1.2 million needles is an unaffordable price for many people. Let’s talk more about the reform of medical insurance, to make medicines “affordable” for everyone, so why can’t “life-saving” medicines be included in medical insurance?
First, let's take a look at why CAR-T cell therapy is so expensive.
First, due to the complex pre-treatment steps , which need to involve all aspects, high-quality clinical treatment and nursing team tracking are also required after the injection, and the cost will naturally rise;
Second, due to the limitations of CAR-T therapy at present , and the inability to apply it on a large scale, it also makes it difficult to share labor costs.
Why can't I get medical insurance?
Zheng Jie, head of the calculation team for the medical insurance negotiation fund, explained that according to the current scope of drug payment, the highest annual expenditure on drugs in the national catalogue is no more than 300,000 yuan, while the price of CAR-T far exceeds the affordability of the fund and the cost of ordinary people. The burden level is not economical, so it was not able to pass the review.
Due to various reasons, the pricing of CAR-T may not be able to achieve "price reduction" in the short term.
However, Professor Zhou Jianfeng of Tongji Hospital Affiliated to Huazhong University of Science and Technology School of Medicine said that with the advancement of technology and craftsmanship, the price of so-called "high-priced drugs" is expected to gradually decline.
3. Is it necessary to treat the cancer at an advanced stage?
If the patient's condition has developed to an advanced stage, he may face two choices: one is to continue the treatment, but there may be a result of "loss of both human and financial resources"; the other is to choose to go home and spend the last time.
Why some cancers can be cured mainly depends on these 3 points:
Tumor type : Some tumors are extremely malignant, such as pancreatic cancer, which is often found to be difficult to recover, while some cancers are relatively “indolent”, such as thyroid cancer, which develops slowly and does not metastasize for several years.
Tumor sooner or later : Staging is the key to determining the prognosis of cancer. The earlier it is found, the earlier the stage, the better the chance of cure.
Standardized treatment : Tumor treatment must be standardized. For example, for stage IIIb lung cancer with N2 lymph node metastasis, the first choice is radical concurrent chemoradiotherapy, and surgery may not be possible to completely remove it.
However, these four cancers may be successfully " cured " even at an advanced stage.
1. Gastric cancer
Gastric cancer is a cancer with a high incidence in China, and there are no specific symptoms in the early stage, so most patients are found in the middle and late stages. At present, except for special cases, the vast majority of gastric cancers are mainly subjected to subtotal gastrectomy, that is, the removal of more than 70%-80% of the stomach.
After the stomach is removed, chemotherapy is also needed. For people with advanced gastric cancer, doctors can reduce the size of the tumor with drugs until it can be removed.
2. Lymphoma
Data show that the incidence of lymphoma in China is about 6.68/100,000, and it is increasing year by year. Lymphoma is also one of the tumors with a high cure rate at present. Through targeted and immunotherapy, the cure rate of lymphoma can reach 70-80% .
3. Prostate cancer
Prostate cancer, known as "men's cancer," is the second most common cancer in men. Compared with liver cancer and lung cancer, prostate cancer has a better prognosis. After standardized treatment, the 5-year survival rate of prostate cancer can be close to 100% .
With the increase in innovative treatment methods, new endocrine drugs have also been approved in China, giving patients more treatment options.
4. Thyroid cancer
Compared with other malignant cancers, thyroid cancer is relatively slow in disease, has a high survival rate, and has a high cure rate, with a survival rate of over 90% .
At present, for the most common differentiated thyroid cancer, the three steps of standardized treatment are "surgical treatment + iodine 131 treatment + thyroid hormone suppression treatment". Even if it develops to the middle and late stages, active and appropriate treatment can still prolong life.
CAR-T cell therapy is still in the early clinical stage, but as more and more treatment "miracles" appear, it is believed that in the future, more cancer patients will be able to "have injections" and "have medicines to eat".
References:
[1] "Using Your Own Cells to Destroy Tumors! Anhui's first beneficiary completed treatment in the First Affiliated Hospital of China University of Science and Technology". Anhui Net. 2022-05-02
[2] "Why is 1.2 million injections of anticancer drugs not covered by medical insurance? The official explanation is here! ". Health Times. 2021-12-03
[3] "Cancer actually "can" be cured! | Road to Health". CCTV Road to Health. 2018-04-16
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