Accreditation, Access, and Outcomes: What Real-World CAR-T Data Tells Us

Debra Patt and Tara Graff open this Insights series by examining why CAR T-cell therapy access remains geographically concentrated, drawing parallels to earlier waves of specialized cancer treatment adoption.

Dr. Graff details how rural geography and unfavorable payer reimbursement compound to limit which community oncology practices can safely and sustainably offer T-cell engaging therapies.

Dr. Porter frames access as CAR T-cell therapy's central challenge, outlining the safety, efficacy, and affordability gains still needed before outpatient administration can meaningfully close the gap for patients.

The panel traces FACT accreditation's origins in transplant medicine and asks whether a decade of improved CRS and neurotoxicity management has outpaced the original rationale for its strict requirements.

Dr. Porter argues FACT accreditation's original rationale for CAR T-cell therapy still holds, even as the standards evolve to fit community programs without loosening quality or safety requirements.

Dr. Graff outlines exactly what FACT accreditation demands operationally, while Dr. Patt argues accreditation should support quality rather than function as a rate-limiting barrier to patient access.

Dr. Porter distinguishes community-based CAR T-cell therapy from non-accredited care, describing why extending treatment beyond academic centers demands the same rigorous standards patients already expect.

Behind every CAR T program is a real cost structure, staffing, drug stocking, and around-the-clock monitoring, that Dr. Graff breaks down as a practical barrier independent of clinical readiness.

Dr. Porter walks through how his health system built two community CAR T-cell therapy sites from scratch, matching academic-level quality before either earned formal FACT accreditation.

As non-FACT-accredited sites increasingly treat patients, the panel examines the calculus practices use to weigh reimbursement risk against growing patient need for CAR T-cell therapy.

New ASCO data comparing FACT-accredited and non-accredited centers show similar patients, similar toxicities, and similar infection rates, though Dr. Porter cautions the claims-based analysis carries real limitations.

New ASCO 2026 real-world data compares safety and outcomes between FACT-accredited and non-accredited centers, challenging assumptions about which sites can deliver CAR T care safely.

Dr. Porter closes with a stark statistic: fewer than 1 in 5 eligible patients ever receive CAR T-cell therapy, and argues deliberate community expansion is the only durable fix.

Dr. Patt and Dr. Graff close with a call to action for policy, payers, and practices to accelerate equitable access to CAR T-cell therapy in community oncology.