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New SMC guidance for DLBCL

Published on: 15 March 2024

The Scottish Medicines Consortium recommends loncastuximab tesirine but not axicabtagene ciloleucel as treatment for diffuse large B-cell lymphoma and high-grade B-cell lymphoma.

Scottish Medicines Consortium

The Scottish Medicines Consortium (SMC) has announced that they will not be recommending the CAR-T therapy axicabtagene ciloleucel for treating people in Scotland with diffuse large B-cell lymphoma and high-grade B-cell lymphoma (HGBL), which has not responded to (refractory) or come back (relapsed) after chemoimmunotherapy.  

CAR-T cell therapy is currently available for people who have had two or more treatments, and a positive decision would have made it available for many more people in Scotland. Last year axicabtagene ciloleucel was approved by NICE for treatment in England by use of the Cancer Drug Fund for this group of patients.

Lymphoma Action was involved in the appraisal process and advocated for access to this treatment for those who need it. We are disappointed in the inequality in access to treatment for people throughout the UK as result of this decision.

More information on their decision can be found here.


In more positive news the SMC has announced that they will be recommending loncastuximab tesirine for treating people in Scotland with DLBCL and HGBL who have relapsed or refractory disease. It is only to be used in those patients who are unsuitable for CAR-T therapy, or where CAR-T therapy has not worked.

Loncastuximab tesirine is a type of antibody-drug conjugate therapy which is a targeted treatment. It is made up of an antibody which sticks to a protein on the lymphoma cells, and a chemotherapy drug which destroys these cancerous cells.  

This treatment has recently been approved by NICE for use by the NHS in England and Wales in the same group of patients. We at Lymphoma Action are pleased that this treatment option is now also available for people living in Scotland.


Find out more about drug development, approval and funding, or visit Lymphoma TrialsLink for the latest on clinical trials for lymphoma.