Communicating the Value of CAR T in the Treatment of B-Cell Lymphoma

Dr Friedman addresses common misconceptions among community oncologists about chimeric antigen receptor (CAR) T-cell therapy toxicities, noting that many believe patients will inevitably experience severe complications like immune effector cell–associated neurotoxicity syndrome, coma, hemophagocytic lymphohistiocytosis, or prolonged hospitalizations with poor outcomes. These misconceptions can inadvertently influence patient decisions, leading them to choose palliative therapies instead of potentially curative CAR T treatment.

The reality demonstrates significant evolution in CAR T safety profiles. Many patients now qualify for outpatient therapy with shorter hospital stays and improved outcomes. Treatment centers have developed expertise in managing toxicities effectively, with comprehensive guidelines provided to community oncologists for posttreatment care. These guidelines cover monitoring requirements, medication management, and clear instructions for ongoing care, with CAR T centers remaining available for consultation on complex cases.

Dr Friedman emphasizes 2 key messages for community oncologists: first, CAR T represents the best available therapy with excellent patient outcomes, and second, posttreatment care is well-standardized with clear protocols. The collaborative relationship between community and academic centers ensures patients receive optimal care throughout their treatment journey. Community oncologists should focus on giving patients their best chance at a cure rather than being deterred by outdated perceptions of treatment toxicity.