Preparing Cancer Centers for Outpatient CAR T-cell Administration

David G. Maloney, MD, PhD, of the Fred Hutchinson Cancer Research Center, reviews the protocols and infrastructure necessary to deliver chimeric antigen receptor (CAR) T-cell therapy to patients receiving treatment in the outpatient setting.

He said that this process requires a robust clinical ability by the centers and administration staff. The agent lisocabtagene maraleucel (liso-cel) has allowed certain academic centers to pioneer this approach, due to lower rate of severe grade 3 cytokine release syndrome and a slower onset of symptoms. This has made the agent more attractive for use in patients who can be closely monitored following the administration of their therapy.

It is important that patients have access to an emergency department that is capable of treating the potential complicating events associated with CAR T-cell therapy immediately, even if symptoms come on in the middle of the night. That means, patients must stay within 20 to 30 minutes of the center for the first few weeks. In addition, daily monitoring with visits to the center are necessary following the first administration.

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