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How community oncologists view CAR T- cell therapy possibilities and challenges


Historically, the mainstays of cancer treatment have been surgery, chemotherapy, and radiation therapy. While this is still the case, for almost a decade now, newer treatments have transformed outcomes for cancer patients – especially those for whom traditional treatments were unsuccessful or had worse side effects.

Modern cell and gene therapies, such as the cellular immunotherapy called Chimeric Antigen Receptor (CAR) T-cell therapy, are part of this new class of treatments.

CAR T-cell therapy is one of the modern cell and gene therapies widely adopted by the medical community in the United States. Since the first products received FDA approvals in 2017, it became an established part of the standard of care for certain blood cancers.

Currently, six CAR T-cell therapies are FDA-approved for treating blood cancers, including lymphomas, some types of leukemia and multiple myeloma. Recent large clinical trials have led medical-community experts to predict that CAR T-cell therapy could soon replace additional chemotherapy as the standard second-line cancer treatment.

At a recent Cardinal Health Specialty Summit, 83 oncology healthcare professionals were surveyed on provider perceptions of CAR T-cell therapy and its evolving role in cancer patient management. Sixty nine of the respondents were physicians, while the rest were non physician healthcare professionals.

The survey found that most physicians (82%) are very comfortable or somewhat comfortable referring eligible patients for cell or gene therapy. This comfort level is reflected in practice when it comes to CAR T-cell therapy. Over half of the physicians surveyed (54%) had prescribed or referred commercial CAR T-cell therapy for one to three patients over the past year, while an additional 28% had referred more than three – sometimes more than 10 patients – to receive the treatment.

As apparent in the survey, most physicians are willing to prescribe CAR T-cell therapies. However, most do not have a structured process to refer patients from the community settings to administering tertiary case institutions. Just over one-third of physician respondents (37%) at the Cardinal Health Specialty Summit reported they have a formal process for CAR T-cell therapy referrals.

During the early years of a novel cancer therapy’s adoption into standard practice, there can be a steep learning curve and extensive time required to understand the intricacies of the clinical trial data. Physician awareness and education is necessary not only to gain comfort but to apply in practice too. This delays the establishment of fixed approaches to identifying patients most likely to benefit from the treatment and the best ways and centers to refer them to.

To learn more about oncologists’ CAR-T perceptions, continued challenges and how biopharma can help mitigate, download the full report here.