Question to the Department of Health and Social Care:

To ask His Majesty's Government which specific CAR-T treatments are available for individuals with low grade lymphomas.

NHS England funds the use of licensed medicines that have been recommended by the National Institute for Health and Care Excellence (NICE), or the off-label use of licensed indications that have been approved via the NHS England clinical policy process.

NICE has evaluated and recommended several CAR-T therapies for both high-grade and low-grade lymphomas, some of which are recommended for a period of managed access, for instance:

• Brexucabtagene autoleucel, for relapsed or refractory mantle cell lymphoma (MA rec) and/or relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged 26 years old and over (managed access);
• Tisagenlecleucel for relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged 25 years old and under;
• Brexucabtagene autoleucel for relapsed or refractory mantle cell lymphoma (managed access) and/or relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged 26 years old and over (managed access);
• Tisagenlecleucel for relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged 25 years old and under;
• Axicabtagene ciloleucel for diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after two or more systemic therapies and/or relapsed or refractory diffuse large B-cell lymphoma after first-line chemoimmunotherapy;
• Lisocabtagene maraleucel for relapsed or refractory large B-cell lymphoma after first-line chemoimmunotherapy when a stem cell transplant is suitable; and
• Obecabtagene autoleucel for relapsed or refractory B-cell acute lymphoblastic leukaemia and/or relapsed or refractory B-cell acute lymphoblastic leukaemia

To support implementation of NICE recommendations, NHS England sets clinical treatment criteria to ensure that treatments are made available to those intended by the NICE Guidance. Clinical input helps set the clinical and patient treatment criteria based on the NICE committee deliberations, how the treatment will be used within the treatment pathway, and the evidence base considered by NICE and the Medicines and Healthcare Products Regulatory Agency.