Adapting CAR-T and Cell Therapies for Community Oncology: Biagio Ricciuti, MD

Translating academic practices into a community oncology setting requires meaningful adaptations to successfully integrate practices like adoptive cell therapy, CAR-T therapies, or TCR-T therapies, Biagio Ricciuti, MD, a medical thoracic oncologist at the Dana-Farber Cancer Institute, said in an interview with The American Journal of Managed^®.

Implementing these therapies into a community setting requires specific infrastructures like cell factories and administration in an inpatient setting due to increased toxicities, which was another key point Ricciuti also emphasized during the Boston Regional Institute for Value-Based Medicine on February 5th. Academic medical centers are often better equipped to manage toxicities associated with newer therapies.

“We never had T-cell engagers available,” Ricciuti said. “And we certainly were behind compared to our colleagues in the hematologic oncology setting.”

Upon adopting these practices at his institution, Ricciuti said it took time for his team and him to feel comfortable using these medications. But developing an infrastructure that allowed them to safely administer the medications to patients helped significantly.

Their protocol involved “scheduling, precisely, admission in the hospital where we would give this therapy,” he explained.

Furthermore, academic center physicians’ and community oncologists’ work often intersects at specific junctures in patient care. For example, at an academic center, Ricciuti and his team may meet multiple new patients who have already established rapport with their community oncologist.

Ricciuti and his team will consult with a new patient, perhaps when the patient’s cancer has progressed, to discuss new trial options and adverse events. But building a relationship with community providers can help the academic centers to provide better continuity of care, he said.

“I think what would be extremely important is to have joint meetings, specifically with satellites or regional hospitals,” Ricciuti explained. “Having regular meetings where, for example, we have a tumor board, and we decide together what's the best approach for a specific patient population for which we have limited data.”