NHS withdraws access to life-extending blood cancer treatment

Patients with a rare and aggressive form of blood cancer will no longer be offered a specialist immunotherapy on the NHS after the health watchdog concluded it did not deliver sufficient benefit in everyday clinical use. The move places the NICE decision on Tecartus at the centre of a renewed debate over how life-extending treatments are judged once they move beyond trials and into routine care.

Tecartus, a form of CAR T-cell therapy that involves reprogramming a patient’s own immune cells to attack cancer, had been available to some people with mantle cell lymphoma for around five years. It was initially approved on a conditional basis, allowing patients access while further evidence was gathered on long-term outcomes.

That access will now end for new patients. The National Institute for Health and Care Excellence said analysis of real-world NHS data showed people treated with Tecartus lived for an average of 2.5 years, significantly less than the four years suggested by clinical trials. On that basis, the treatment was deemed no longer cost-effective.

Patients already receiving the therapy will continue to do so, but clinicians will not be able to refer new cases. Mantle cell lymphoma affects around 600 people a year in the UK and is known for returning after initial treatment. Tecartus, also known as brexucabtagene autoleucel, is the only CAR T-cell therapy approved for this disease.

The decision has prompted an appeal from Blood Cancer UK, Lymphoma Action and the stem cell charity Anthony Nolan, which argue that removing access risks abandoning patients with few remaining treatment options.

Dr Rubina Ahmed, director of research, policy and services at Blood Cancer UK, said the ruling failed to reflect the reality faced by patients whose cancer has returned or resisted previous therapies. “For some people with mantle cell lymphoma, this treatment represents a last realistic hope of a cure,” she said. “We recognise the complexity of these decisions, but we are deeply concerned about what this means for people who have very limited alternatives.”

That concern is shared by frontline staff. Emily John, a CAR T-cell therapy specialist nurse at Anthony Nolan, said the therapy had transformed outcomes for some patients who would otherwise have exhausted all options. “The removal of the only CAR T-cell therapy available for mantle cell lymphoma is incredibly troubling,” she said. “It feels like a backward step for NHS care.”

For patients such as Paul Madley, 66, from Cardiff, the decision has landed with particular force. Diagnosed with stage 4 mantle cell lymphoma in 2021, he underwent multiple rounds of chemotherapy before his cancer returned in 2024. He was referred for CAR T-cell therapy later that year and was told in March 2025 that he was in remission.

“I’ve been able to return to work, walk my dog most mornings, play golf and live my life much as I did before,” he said. “To hear that this treatment is now being withdrawn is truly unbelievable. I feel sadness, disappointment and anger. Without it, I honestly don’t know where I would be.”

NICE said its independent committee had considered patient testimony alongside data collected through almost five years of NHS use via the Cancer Drugs Fund. A spokesperson said the decision would be distressing for patients and families but added that evidence showed the treatment did not perform as strongly in practice as it had in trials.

How medicines are assessed for NHS funding is set out in guidance published by the National Institute for Health and Care Excellence, which weighs clinical benefit against cost to the public health system.

For more independent coverage of NHS policy, medical research and the decisions shaping patient care, follow EyeOnLondon. We welcome thoughtful discussion in the comments.

[Image Credit | RMDM Group]

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