Community Oncology Must Adapt for CAR T, Bispecific Multiple Myeloma Care: Mohit Narang, MD

Translating care from academic centers to community practices is essential in multiple myeloma care, especially when considering chimeric antigen receptor (CAR) T-cell and bispecific therapies—a pivotal point at a recent Washington, DC, Institute for Value-Based Medicine (IVBM) event.

The panel discussion of the IVBM event, held on June 25, 2026, featured multiple speakers within the therapeutic area to address translation gaps in this particular subset of care for patients with multiple myeloma. One of the panelists, Mohit Narang, MD, a medical hematologist and oncologist at Maryland Oncology Hematology, sat on the panel titled “Scaling Innovation: Delivering Targeted Therapies, CAR T, and Bispecifics in Multiple Myeloma,” providing clinicians with practical insights necessary for managing care for this disease.

In an interview with The American Journal of Managed Care^®, Narang addressed the varying patient demographics each institution serves, underscoring location barriers and the exclusion of community practices from clinical trials.

“The patients who live quite far from an academic institution, they cannot go to those places, so even though we have excellent treatment modalities available, these patients can’t get access,” he said.

Narang also noted that the infrastructure of community oncology practices was not designed to accommodate patients being treated with CAR T or bispecifics, as the majority receive long-stay inpatient treatment.

“[But] if you look at all the new bispecific and CAR T therapies, we’re doing them in an outpatient setting,” he said.

Outpatient settings have a decent amount of practice delivering this care and managing toxicities and multidisciplinary communications for patients, in addition to long-term follow-up, Narang said during the panel discussion.

“We have to train our intensivists, our hospitalists, and the ER [emergency room] physicians so that they know if there's an ICANS [immune effector cell–associated neurotoxicity syndrome] or CRS [cytokine release syndrome] happening,” he said. “[Also], if a patient is going to a university setting, I'm talking to that provider on a one-to-one basis. I need to know the patient was seen and if they have any issues, because when they come back to my place, I need to take care of them.”