Join Drs. Caimi and Sdrimas for a focused discussion on the coordination of CAR-T therapy between academic and community practices. As CAR-T use expands, ensuring seamless communication and shared responsibilities between care teams is essential. Using a real-world patient case, this episode explores how to navigate logistics, manage toxicities, and support patients in both settings—delivering collaborative, high-quality care.
Learning Objectives:
1. Understand the shared roles and responsibilities in CAR-T patient management across care settings
2. Identify communication strategies that support safe and effective care coordination
3. Explore real-world barriers and solutions to bridging academic and community practice collaboration
Clinical Pearls:
- Early and Appropriate Referral is Crucial:
- Community oncologists should refer patients early in the disease course. Being ineligible for transplant does not mean a patient is ineligible for CAR-T. Timely referral (i.e. before any other therapy is started unless clinically needed) allows for proper evaluation, manufacturing logistics, and bridging therapy if needed.
- Clear, Bidirectional Communication is Key to Safe Co-management: Successful shared care relies on:
- Identified point persons at both the academic and community sites (often including nurse coordinators).
- Timely updates about treatment timelines and toxicity events. Ideally, same day if a toxicity occurs. Weekly updates for treatment timelines.
- Use of standardized handoff templates and direct lines of communication to ensure continuity, safety, and efficiency in post-infusion monitoring.
- Empowering the Community Practice Enhances Access and Outcomes:
- Academic CAR-T centers, hematologists, nursing staff, and CAR-T coordinators educating community providers on late toxicities, infection risks, and long-term monitoring enables safe local care.
Helpful resources:
https://ashpublications.org/blood/article/141/20/2405/494965/Introduction-to-a-How-I-Treat-series-on-emergent
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00094-9/abstract
https://www.astct.org/Education/Practice-Guidelines
