Beyond AMCs: CAR Ts and Bispecifics in Community Oncology

CAR T-cell and bispecific antibody (BsAb) therapies are defensibly the most powerful cancer therapies available for approved tumor types. However, since CAR Ts and BsAbs are mostly used in academic medical centers (AMCs) and affiliated outpatient clinics, access is limited for thousands of eligible patients who do not live close to these institutions. Expanding these treatments to community oncology practices could theoretically improve access, but many clinical, logistical, and financial barriers continue to limit this opportunity. 

The team took a closer look at our latest Special Topic Report, focusing on 3 key questions:

1. Are CAR Ts and/or BsAbs treatment options viable in the community oncology setting?
2. What are the major barriers to adoption?
3. Where and how do they best fit?

Several BsAb treatments demonstrate greater overall feasibility in the community oncology setting than CAR Ts, but mostly during maintenance dosing cycles. Florida Cancer Specialists is an example of a community provider group that manages maintenance dosing after partnering with local hospital systems that deliver early cycles. As provider experience with BsAbs improves and the market grows, providers in the community oncology setting are likely to first adopt BsAbs that have the simplest initial dosing schedules, easiest monitoring recommendations, and safest adverse event profiles. 

Manufacturers have several opportunities to support the appropriate use of BsAbs in the community:

• Play a significant role in supporting community practice provider and patient education for BsAbs; 
• Be ready to provide information to practices assessing opportunities for delivering CAR T;
• Educate and support local hospitals looking to build or support BsAb programs; and,
• Support community oncology practices navigating the financial complexities of BsAbs.

Have questions? Reach out to me at: cvandenburg@hmpglobal.com.