Mia Cara Ferreira is a six-year old South African girl who has been battling Acute Lymphoblastic Leukaemia (ALL) since 2015. Mia Cara’s parents are now seeking an alternative solution after she unexpectedly relapsed in May 2017 after months of intensive treatment.
CAR T-cell therapy is an entirely new, much-anticipated class of treatment that is causing a ripple of excitement within and beyond the medical world – and Mia Cara is set to be the first person from Africa to receive this treatment.
CAR T-cell therapy, unlike conventional Chemotherapy, is a gene-editing treatment by which the patient’s own cells are harvested and re-engineered to act as “killing machines” within the body.
The process involves the modification of T-cells (known as immune cells), after which they are reintroduced to the body to attack and destroy cancer cells. The treatment has been referred to as one of the most exciting developments in oncology and childhood leukaemia in decades, and has yielded particularly good results with regards to the treatment of ALL.
Currently only available in the USA, CAR T-cell therapy has been described by medical professionals as nothing short of incredible. The Children’s Hospital of Philadelphia (CHOP) implemented a trial phase in August 2011, which saw an 83% remission rate within three months of treating the 68 children who participated in the study.
The United States Department of Health and Human Services’ Food and Drug Administration (FDA) approved the first CAR T-cell drug (Kymriah™) in August 2017, which means that the benefits of its use outweigh the potential risks associated with its use.
This form of treatment is in stark contrast to Mia Cara’s previous treatments and future reality, which was to receive another round of intensive chemotherapy, radiation and a bone marrow transplant in South Africa – IF a suitable bone marrow donor could be found – Mia Cara would have to experience the terrible side-effects of each therapy and even then face a mere 40% chance of remission.
Mia Cara’s father, José Ferreira said: “CAR T-cell therapy offers an alternative solution to the extremely risky process of receiving chemotherapy, a bone marrow transplant and radiation that Mia Cara would have to endure otherwise. She is only six years old and we are not willing to risk the long-lasting side effects of these therapies, which could include brain damage. Our wish as parents is to give our child the best chance of survival and to try minimise the risks and the side effects, especially since she relapsed after receiving intensive treatment for more than 21 months.”
Since her recent relapse, Mia Cara has been accepted as part of the ongoing CAR T-cell therapy programme at CHOP. She recently underwent the initial cell harvesting process – these cells are being modified in a laboratory and will be kept frozen until she is ready to start the next phase of treatment at CHOP, which is scheduled for 2 January 2018. Doctors are hopeful that, after being infused back into Mia Cara’s bloodstream, the re-engineered cells will continue to multiply and will potentially last for months – even years – preventing any further relapses and ridding her body of the cancer altogether.
The downside is that CAR T-cell therapy is still highly unaffordable due to the specialised nature of the procedure and will cost the Ferreira family in excess of R10 million over the next two years, excluding the laboratory costs which amount to around R5.8 million but which will be covered as part of the trial.
The family’s medical aid won’t cover these costs and they have embarked on various fundraising campaigns to raise the funds to help Mia Cara undergo this life-saving treatment.
Comments José: “Considering the shocking 4% recovery rate for those South Africans who undergo certain cancer treatment without a bone marrow donor, it is imperative that South Africa gains access to alternative solutions, such as CAR T-cell therapy. It is our sincerest hope that this treatment will ultimately change the future for so many other South African children who are in dire need of alternative treatment for ALL. It would make the world of difference if this treatment became available in our own country and across Africa.”
We hope so too, José!!