Written Question: CAR-T

Lord Moylan: To ask His Majesty's Government what assessment they have made of the impact on patients of withdrawing access to an existing cancer treatment, namely CAR-T therapy for relapsed or refractory mantle cell lymphoma, which has been available on the NHS since 2021.

Lord Moylan: To ask His Majesty's Government how many patients have received CAR-T therapy for mantle cell lymphoma via the Cancer Drugs Fund; and what assessment has been made of the clinical outcomes for those patients.

Parliamentary Under Secretary of State, Department of Health and Social Care (Lady Merron): 202 patients have received brexucabtagene autoleucel, a form of CAR-T therapy, for the treatment of mantle cell lymphoma via the Cancer Drugs Fund (CDF). This data is taken from NHS England’s prior approval system. The National Institute for Health and Care Excellence (NICE) is currently re-evaluating the evidence on clinical outcomes collected through its use in the CDF in its ongoing re-evaluation of brexucabtagene autoleucel.

NICE published final draft guidance on 24 December 2025 in which it was not able to recommend brexucabtagene autoleucel for the treatment of relapsed or refractory mantle cell lymphoma in adults who have had two or more lines of systemic treatment that included a Bruton's tyrosine kinase inhibitor. This is because the extent of brexucabtagene autoleucel’s clinical benefit is uncertain. There are also uncertainties in the economic model because there is not enough evidence to tell if the cancer can be ‘cured’ in people having brexucabtagene autoleucel and it is not known how long people live after having brexucabtagene autoleucel. The cost-effectiveness estimates are also substantially above the range that NICE considers an acceptable use of National Health Service resources. NICE has not yet published final guidance and stakeholders have recently had an opportunity to appeal NICE’s recommendations.

The Government recognises that the potential withdrawal of brexucabtagene autoleucel as a treatment for future patients will be concerning for patients and their families, but it is right that these decisions are taken independently and on the basis of the available evidence. In line with an arrangement between NHS England and the company, if NICE’s final guidance does not recommend use, patients who started treatment during the managed access period can continue their treatment.