The delivery of CAR T-cell therapy requires workforce and infrastructure not necessitated by more traditional cancer therapies, such as chemotherapy and radiation. While sustained remission and improved survival for patients with hematologic malignancies has led to a growing interest in CAR T-cell therapy among community cancer providers, there is a wariness among lesser-resourced programs and practices to take steps to offer CAR T-cell therapy. Smaller community cancer programs have expressed a preference for referring patients who are candidates for CAR T-cell therapy to larger cancer programs and academic medical centers, due to unfamiliarity with the therapy; inadequate reimbursement for steep costs; insufficient infrastructure; and the potential for unfamiliar life-threatening toxicities in patients.
In a series of surveys in 2016 and 2017, of nearly 400 US community oncologists/hematologists and practice administrators representing a diverse mix of practice types and geographic regions, 64% said the biggest barrier they face to successfully implementing CAR T-cell therapy is the logistics involved in administering treatment and patient follow-up.
ACCC, with support by Bristol Myers Squibb, Janssen Oncology, and Legend Biotech, is helping community cancer programs and practices of all sizes gain the education they need to offer CAR T-cell therapy, sharing effective practices on overcoming logistical and financial hurdles, and highlighting tips on the operational infrastructure (eg, care coordination and patient support) required for a successful program.
For more information on this program, please contact the ACCC Provider Education department.
As interest in expanding chimeric antigen receptor (CAR) T-cell (CAR T) therapies beyond small clinical trials to cancer programs across the country grows, providers are seeking key strategies and effective practices on how community cancer centers can overcome the infrastructural and financial hurdles of implementing CAR T-cell therapies locally. While challenging, the impact of offering commercial CAR T-cell therapy in small and large practices on patients and their continuity of care is tremendous and practices are eager to bring this emerging therapy into their communities. This two-article series explores how the cancer programs at the Billings Clinic Cancer Center and Fox Chase Cancer Center successfully evolved from clinical trial sites to centers for commercial CAR T-Cell therapy in their communities.
As CAR T-cell therapy continues to show promise as an effective treatment for patients with acute lymphocytic leukemia, non-Hodgkin's lymphoma, and multiple myeloma, understanding the nuances of bringing this therapy to outpatient and community care settings is critically important.
In this four-part article series, ACCC highlights effective practices to identify and assess patients who may qualify for treatment, optimize care coordination between referring providers and accredited treatment centers, understand reimbursement associated with treatment, and spotlight cancer programs that have been successful in implementing CAR T-cell therapy in the outpatient setting.
As CAR T-cell therapy continues to show promise as an effective treatment for patients with acute lymphocytic leukemia, non-Hodgkins lymphoma, and multiple myeloma, it has become increasingly important for oncology providers and community-based cancer programs to be proactive in identifying patients who could benefit from this form of therapy. ACCC outlines essential steps for the identification, selection, and assessment of patients who may qualify for this life-saving treatment.
