A new initiative to expand access to CAR T-cell therapy for patients with large B-cell lymphoma (LBCL) is gaining momentum, with experts emphasizing the crucial role of early referral and collaboration between academic centers and community practices.
Dr. David L. Porter, director of Cell Therapy and Transplant at the University of Pennsylvania School of Medicine, presented findings from a groundbreaking community oncologist roundtable at the 2024 Transplantation and Cellular Therapy Meetings. The roundtable established a new framework for CAR T-cell consultation, crystallized in the memorable slogan "If they RECUR, you should refer."
Bridging the Treatment Access Gap
The initiative addresses a critical need in the treatment landscape for LBCL patients. "Early referral is important," emphasizes Dr. Porter. "The 'U' in RECUR stands for 'urgency to recommend consult.' We think the sooner a patient gets into the treatment center, the more likely they will be able to access the treatment."
Collaborative Care Model
The framework promotes a team-based approach between academic centers and community practices. Treatment centers are encouraged to maintain close communication with community physicians, providing consultation, education, and ongoing support. This collaborative model ensures seamless patient care from initial referral through treatment and follow-up care.
Implementation Strategy
The initiative outlines several key components for successful implementation:
- Immediate referral upon disease recurrence
- Expert evaluation at specialized centers to determine eligibility
- Comprehensive communication between treatment centers and community practices
- Structured support system for community physicians
- Clear protocols for patient transfer and return to community care
"The treatment center can provide excellent care and management, but they can also provide excellent consultation and education and be a resource for those practices to learn from and to lean on once the patient goes back to the community," Dr. Porter explains.
Clinical Impact and Safety Considerations
Early referral not only improves access to CAR T-cell therapy but potentially enhances treatment outcomes. Dr. Porter notes that earlier intervention may lead to improved safety profiles and increased treatment effectiveness, underscoring the importance of timely referrals for optimal patient care.
