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Barriers and bridges: real-world CAR T delivery across US oncology practices

Published

November 2025

Citation

Nishihiori T, Kaur M, Langerman S, Fullerton C, Sawas A. Barriers and bridges: real-world CAR T delivery across US oncology practices. ASH Annual Meeting. 2025.

Overview

CAR T-cell therapy represents a significant advancement in cancer treatment; however, delivery of this therapy remains variable across academic and community practices in the US. This real-world study leveraged the Flatiron Health Research Database to evaluate national patterns of CAR T utilization, referral dynamics, and access barriers.

Researchers found that CAR T utilization has steadily expanded since 2017, with most patients receiving treatment at academic centers. However, findings underscore  that community practices play a substantial and growing role in access, specifically in regions with fewer academic sites. By understanding these challenges, the study aims to provide a roadmap for overcoming operational barriers and ensuring broader, equitable access to CAR T therapy nationwide.

Why this matters

CAR T-cell therapy is a groundbreaking treatment for certain blood cancers. Yet, real-world delivery depends on complex logistics: referrals, manufacturing, and infusion infrastructure, that can limit access. Understanding where and why these challenges occur is critical to optimizing care delivery. This research highlights the growing feasibility of community-based CAR T administration and underscores the need for scalable, regionally adaptive delivery models to ensure equitable access for all eligible patients.

 

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