Addressing CAR T Challenges: Enhancing Collaboration for Patient Care

Experts are highlighting the lack of standardization in patient management and use of chimeric antigen receptor (CAR) T-cell therapies for the hematologic malignancies multiple myeloma (MM) and lymphoma, as they call for greater collaboration between non–CAR T and CAR T–treating teams throughout the patient journey, according to a poster presented at the recent Association of Cancer Care Centers 50th Annual Meeting and Cancer Center Business Summit.

A team from Bristol Myers Squibb (BMS) and the Rutgers Pharmaceutical Fellowship Program underscored the need for stepped-up awareness of and education on the use of CAR T between treatment teams due to the rapidly evolving treatment landscape, noting there are knowledge gaps, staff shortages, and turnover at community centers contributing to this need. This occurs despite numerous points in the CAR T treatment journey that necessitate collaboration, with the poster authors pointing to 3 specific instances:

• When patients are referred for CAR T from their treating hematologist/oncologist
• At the CAR T treatment center during discussions on bridging therapy
• Over the long-term follow-up and monitoring of patients following treatment administration

Collaboration is important when treating patients who will receive CAR T or who may be candidates for the therapy | Image Credit: S.... - stock.adobe.com

“Currently, there remains substantial opportunity to increase awareness and education about the place of CAR T-cell therapy within these disease treatment landscapes,” the authors emphasized. “Closing this knowledge gap would contribute to reducing barriers to access for many patients to these therapies.”

Throughout 2023 and in early 2024, the team engaged in discussions with academic and community health care providers (HCPs) to identify how to better the educational process surrounding CAR T by first identifying prominent gaps, and 6 priorities were identified:

• Education and resources on CAR T referrals
• Education on eligibility and sequencing for CAR T
• Education on the connection between bridging therapy efficacy and CAR T efficacy
• Resources to help overcome barriers to CAR T
• Resources for community HCP patient management after CAR T
• Educational materials that are simple, concise, and accessible

Specifically regarding MM, the team found barriers to optimizing CAR T that include patients with triple-class–exposed MM having a poor prognosis, community HCPs saying they don’t know enough about both the patient CAR T journey and how the therapy is manufactured, lack of access to CAR T at the HCP’s institution, and not knowing where or how to refer patients for CAR T.

Using these findings, the BMS Medical Affairs Team and its Field Medical and Cell Therapy Medical partners aimed to create comprehensive educational resources that community HCPs would have access to for patients with MM or lymphoma. They built the CAR T Academy and Cell Therapy 360 websites for community providers and HCPs, respectively. The former contains CAR T modules that cover the various steps in the patient journey for a high-level overview of CAR T for both those directly involved in the process and non–CAR T practitioners, and the latter contains resources that HCPs can pass on to their patients.

Overall, they stress the importance of open communication among the institutions treating the patients and non–CAR T hematology/oncology practitioners, as well as nurses, advanced practice providers, and pharmacy staff, with this last group playing crucial roles in long-term patient management post CAR T.

“In the future, we hope to continue and improve our interactions with our community providers to provide awareness and education of CAR T in MM and lymphoma,” the write. “Our team’s goal is to continue to expand our community engagement, specifically to expand to additional community oncology providers.”

Reference

Machado J, Basu J, Peck A, et al. Bringing CAR T education and awareness to the hematology/oncology community. Presented at: Association of Cancer Care Centers 50th Annual Meeting and Cancer Center Business Summit; February 28-March 1, 2024; Washington, DC.