Early Data Show Promising Outcomes as CAR T-Cell Therapy Expands Beyond Academic Centers

Expanding access to novel cancer treatments such as chimeric antigen receptor (CAR) T-cell therapy to more patients can happen only if the treatments can reach patients where they are—and that means offering them not just in academic centers but also in community practices.

More recently, CAR T-cell therapy has moved into newly authorized treatment centers (ATCs). Data from a pair of abstracts presented during the recent American Society of Hematology Annual Meeting and Exposition in Orlando, Florida suggest these newer ATCs are successfully delivering CAR T-cell therapy with outcomes on par with established academic centers.1,2

Olalekan Oluwole, MBBS, MD | Image: VUMC

Olalekan Oluwole, MBBS, MD, associate professor of medicine in hematology/oncology at Vanderbilt University Medical Center, spoke with The American Journal of Managed Care(AJMC) about his 2 abstracts, which examined real-world healthcare resource utilization and clinical outcomes at these newer centers.1,2

The Evolution of CAR T Access

When the first CAR T-cell therapies received FDA approval in 2017,3,4 Oluwole said they were rapidly adopted by major academic centers such as Vanderbilt, UCLA, the University of Pennsylvania, Moffitt Cancer Center, and The University of Texas MD Anderson Cancer Center. “They are the academic centers. They had all the expertise,FACT accreditation,3 and those were the centers that generated the early real-world data including many publications centered on how to improve the safety profile of this new therapy and how to carefully move them to the outpatient setting,” he said.

FACT accreditation refers to rigorous quality and safety standards set Foundation for the Accreditation of Cellular Therapy; this voluntary, peer-driven process can offer assurance to patients and physicians of high-quality care from cell collection to administration.5 FACT standards, which can cover clinical practice, labs, donor management, and long-term follow-up, require documentation and on-site inspections that can take significant time to complete.5 The rapid adoption of CAR T-cell therapy resulted in a backlog for FACT accreditation.

Starting around 2023, a pattern arose in which a new wave of community oncology centers began offering CAR T-cell therapy. “The newer centers are often not FACT accredited, because the process could take up to 2 years, even when the centers are ready, just because of the backlog,” Oluwole explained. Despite a pending FACT accreditation at launch, these centers were authorized to provide treatment.

“We realize that these centers that are coming on board later may not be as experienced as the academic centers that were part of the early clinical trials and early onboarding,” Oluwole said.

The question is, can they get the job done?

“How well are they able to provide CAR T?” Oluwole said. “And what we found is that they actually did pretty good.”

Real-World Resource Utilization

The first abstract analyzed open claims data from HealthVerity Marketplace dataset from 43 patients who received CAR T therapy across 4 new ATCs between July 2023 and June 2025. The study showed a gradual increase in CAR T-cell therapy adoption over time, with fewer than 11 patients treated in 2023, 16 in 2024, and 22 in the first half of 2025.

Key findings included a mean length of stay for infusion-related hospitalization of 18.0 days for patients with blood cancers other than multiple myeloma (MM) and 11.4 days for patients with MM . Of note, 30-day readmission rates were low—less than 18% for patients without MM and less than 15% for patients with MM. Admissions to the intensive care unit were not reported either at initial hospitalization or readmission.

“The outcomes in terms of the number of days in the hospital, the rate of adverse effects like cytokine release syndrome and neurological events, was really comparable to the academic centers,” Oluwole said.

Inpatient vs Outpatient Administration

The second abstract examined 38 patients treated between January 2024 and January 2025, with nearly half (47.4%) receiving CAR T-cell therapy in the outpatient setting. This comparison revealed important insights about resource utilization.

Patients treated in an outpatient setting who later required admission spent an average of 12.1 days in the hospital, compared to 18.8 days for subsequent admissions among those initially treated in an inpatient setting. The initial CAR T stay for those treated in an inpatient setting averaged 19.1 days.

“Even though it is a 6- or 7-day difference, that is huge, because we know the cost of the hospital bed for a day,” Oluwole emphasized. “And not only that, but the patients who actually are outpatient, they feel better—their quality of life is better.”

Patient Selection for Outpatient Care

Determining which patients can safely receive CAR T-cell therapy in an outpatient setting requires careful consideration. “This is really the art of medicine,” Oluwole said. “It is not one-size-fits-all.”

Key factors include whether patients are “otherwise relatively fit, they have a reliable caregiver, maybe a good means of transportation, and lodging nearby.” And, he said, physicians need to have confidence that “if we need them to come at 2 a.m. that they can show up promptly to get necessary therapy.”

Asked to comment about patients who lack caregivers, Oluwole noted an emerging solution. “There is actually a growing trend now to use paid caregivers, and that is really kind of new, and it is unique, and maybe that will fill the gap.” Questions remain whether insurance will pay for these services.

Expanding Treatment Boundaries

The newer centers are also treating patients who might have been excluded from early clinical trials. “Once CAR T-cell therapy became approved, the academic centers provided rapid publications about how to extend this highly effective therapy to patients that may not have been eligible for the clinical trials—even people who are a little bit sicker, maybe more frail. It is reassuring to see that the data are being carefully utilized,” Oluwole said.

CAR T-cell therapy serves the same demographic pool of patients it always has, he said, but with expanded geographic access, patients can dramatically reduce how much they travel.

While some patients still require extended hospitalizations—particularly those with high tumor burden or who have received multiple lines of chemotherapy—Oluwole said, “With early interventions, the vast majority are recovering earlier and many are now able to go home earlier than before.”

References

1. Oluwole O, Lakzadeh P, Lau C, et al. Real-world healthcare resource utilization (HCRU) following CAR T-cell therapy in US patients treated in newly authorized treatment centers. Presented at: 67th American Society of Hematology Annual Meeting and Exposition, December 6-9, 2025; Orlando, FL. Paper 4411.
2. Oluwole O, Hsu H, Ong S, et al. Outcomes of inpatient and outpatient chimeric antigen receptor T-cell therapy (CAR T) in newly authorized treatment centers (ATCs) in the United States. Presented at: 67th American Society of Hematology Annual Meeting and Exposition, December 6-9, 2025; Orlando, FL. Paper 6284.
3. FDA approves tisagenlecleucel for B-cell ALL and tocilizumab for cytokine release syndrome. FDA. Updated September 7, 2017. Accessed December 19, 2025.https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-tisagenlecleucel-b-cell-all-and-tocilizumab-cytokine-release-syndrome
4. FDA approves axicabtagene ciloleucel for large B-cell lymphoma. FDA. Updated October 25, 2017. Accessed December 19, 2025. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-axicabtagene-ciloleucel-large-b-cell-lymphoma
5. What FACT accreditation mean to patients and families. Foundation for the Accreditation of Cellular Therapy. Accessed December 19, 2025. https://www.factglobal.org/accreditation-process/what-fact-accreditation-means-to-patients/