42%
of respondents were not familiar with current efficacy and toxicity data on CAR-T. Only 20 percent had referred patients to CAR-T cell therapy in the past 12 months.
Barriers to CAR-T therapy adoption: 3 key findings
Chimeric antigen receptor T-cell therapy, more commonly known as CAR-T therapy, has been hailed as a potentially game-changing cancer treatment with extraordinary promise. Representing a new frontier in immuno-oncology and gene therapy, CAR-T therapy has demonstrated rapid and complete responses in highly refractory patients in clinical trials. Emerging data has clearly shown CAR-T’s significant potential for improved outcomes in relapsed/refractory DLBCL, primary mediastinal B-cell lymphoma, chronic lympocytic leukemia and acute lympoblastic leukemia.
With the recent FDA approval of two new treatments, CAR-T is now making its way to market. In spite of its significant potential, the degree to which oncologists will refer patients for CAR-T therapy is still unknown. CAR-T manufacturers have indicated to the FDA that treatments will be initially limited to highly-specialized centers capable of stem cell transplantation. However, with the majority of cancer patients being seen in the community setting, the perception of this treatment among community oncologists will be vital to its success, patient referrals, and initial adoption.
Cardinal Health Specialty Solutions conducted research to better understand the challenges that may hinder community oncologists’ use and referral of CAR-T therapy. The findings were published in the October 2017 issue of Journal of Clinical Pathways.
Key findings:
Research was based on the perceptions of nearly 400 U.S.-based community oncologists/hematologists and practice administrators, gathered during six live meetings conducted between November 2016 and June 2017. Respondents were from a diverse mix of practice types and settings and represented all geographic areas of the U.S.
The results of the data collected revealed three key factors that could inhibit adoption and referral of CAR-T therapies: a lack of understanding/familiarity with the treatment, the site of administration and the toxicity profile.
46%
of respondents planned to refer eligible patients to academic centers. One-third of respondents indicated that they would rather treat some patients locally while referring others to academic sites.
>60%
of respondents believed that patients should be monitored 1-2 weeks after administration.
One-third of respondents said that the toxicity profile was a possible deterrent to prescribing CAR-T therapy.
Nearly one-fourth stated that involving a critical care specialist would optimize toxicity management.
Of all three barriers to successful implementation, 64 percent of respondents said that the logistics of administering and following up with patients would be the most challenging.
Overall, physicians seem receptive to prescribing CAR‑T—only 22 percent indicated that they were unlikely to prescribe this therapy. However, these three factors are critical to understand and could possibly hinder the market adoption of this therapy.
64%
said the biggest barrier to successful implementation of treatment is the logistics involved in administering the treatment and patient follow up.
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Bruce Feinberg, DO
Vice President, Chief Medical OfficerCardinal Health Specialty Solutions
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