Bringing CAR T and Bispecifics to the Community

Andrew Dalovisio, MD, a hematologist/oncologist at Mary Bird Perkins Cancer Center in Baton Rouge, Louisiana, discusses how his community cancer center built a CAR T and bispecific antibody program from the ground up. He walks through the toxicities associated with these T-cell–engaging therapies, including cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS), and explains how prophylactic measures and a robust home-monitoring program have made outpatient management feasible. Dalovisio also addresses disparities in access, including insurance coverage gaps and the caregiver burden patients face, updates on risk evaluation and management (REMS) program changes affecting travel restrictions, and long-term complications like cytopenias and neurotoxicity that require coordination with academic centers. He closes with advice for oncologists on counseling patients as these therapies move toward earlier lines of treatment.