CAR T-Cell Therapy Access Expansion for LBCL Sees “Early Success”

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It may be applicable to administer CAR T-cell therapy to patients with large B-cell lymphoma in a community or outpatient setting.

Bringing CAR T-cell therapy to a community setting for patients with large B-cell lymphoma (LBCL) may have a “major impact” on treatment access for those who otherwise wouldn’t have received a referral, according to David L. Porter, MD.

In a conversation with CancerNetwork® during the 2024 Transplantation and Cellular Therapy Meetings, Porter, the director of Cell Therapy and Transplant at the University of Pennsylvania School of Medicine, discussed ongoing initiatives for expanding access to CAR T-cell therapy for those with LBCL. He spoke about these efforts in the context of a community oncologist roundtable that aimed to establish a framework for quickly identifying patients who may be suitable for CAR T-cell therapy consultation.

Porter and his group organized an effort to bring CAR T-cell therapy to patients in community hospitals as an alternative to making patients travel to a major medical center to receive treatment. He said that this initiative has resulted in some early successes and that it would likely expand in the future.

Transcript:

It's very hard to make big differences in providing access to patients who must travel great distances, pick up their lives, leave work for many weeks at a time, and have a caregiver. Are there ways that this kind of therapy can be brought closer to where the patients are, rather than insisting the patients come to the therapy?

We have been working with several community hospitals in our health system that are a distance from our major medical center. We believe, as these therapies become safer, as we understand the toxicity and toxicity management, that these therapies, in fact, may be appropriate—at least in some cases and with some of the CAR T-cell products—to be used in a community setting and even in an outpatient setting. A major initiative we have is trying to develop processes and programs to be able to give CAR T-cell therapy in the community setting, although insisting on maximal safety and making sure we preserve efficacy and appropriate quality oversight. But as the treatments have gotten safer and we know how to manage [the toxicities], we've had some early successes bringing this out in the community. We think that that initiative is going to expand in the future. That will have a major impact on providing access to people who otherwise either wouldn't be referred or might be referred or recommended to a treatment center but either choose not to access it or just can't for all the reasons we've discussed.

Reference

Riedell PA, Downs C, Boehmer L, Ebmeier J, Porter D, Williams A. If They RECUR, you should refer: a community oncologist patient ID roundtable summary. Transplantation and Cellular Therapy. 2024;30(1):14-16. doi:10.1016/j.jtct.2023.10.019

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