Administering CAR T-Cell Therapy in the Community Setting

Peter A. McSweeney, MD, hematologist/oncologist at the Colorado Blood Cancer Institute, discusses the challenges that come with administering chimeric antigen receptor (CAR) T-cell therapy. He also explains how CAR T cells entering the second-line may change the ways community practices choose treatments for their patients.

The key challenge that small community practices face when administering patients CAR T-cell therapy is the lack of infrastructure. While larger practices have similar resources to those in academic centers, smaller practices often require a referral to an academic center in order to give a patient CAR T-cell therapy.

According to McSweeney, with CAR T cells now entering the second-line setting for various cancer types, community practices need to keep in mind how they can incorporate this into the treatment strategy for patients at first relapse. For physicians not administering this CAR T-cell therapy, it is important to get patients referred quickly and to the correct site.

Transcription:

0:08 | The biggest challenge for administering these CAR T cells in the community is developing a program that has the appropriate expertise and infrastructure for this type of work. It's a very multifaceted type of therapy, it draws on inpatient and outpatient arrangements that meet the needs of the patients, and there is a need for subspecialty support in the hospital for patients who have complications with the therapy.

0:36 | What I think is very important for second-line therapy is that the community practice is aware of these changes because patients are now moving into this as the therapy at first relapse, or at least incorporate this into the treatment strategy at first relapse, so one needs to know this. In some instances, the timing of therapy and the urgency of referral is a big issue. The physicians in the community who are not administering this therapy need to be aware and get the patient referred quickly to the appropriate places, particularly for diseases like diffuse large B-cell lymphoma in initial relapse or that is resistant to primary therapy.