Bridging the Gap: Coordinating CAR-T Care Between Community and Academic Practices

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:

1. 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. 
2. 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.
3. 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