US: Identifying patients who are eligible for CAR T-cell therapy

For CAR T-cell therapy, timely identification and referral are important first steps in helping eligible patients get the most out of treatment. However, HCPs, patients and caregivers may be unsure about whether to pursue this type of treatment. Delays in referral could lead to disease progression, making some people ineligible for CAR T-cell therapy.⁸ 

In 2024, the American Society for Transplantation and Cellular Therapy (ASTCT), the Association of American Cancer Institutes (AACI), and the Association of Cancer Care Centers (ACCC) launched the RECUR initiative – a multidisciplinary program that aims to empower oncologists, HCPs and patients with a strong understanding of the factors needed for successful CAR T-cell therapy.⁸⁴

The three organizations took part in a roundtable to identify and prioritize the factors involved in CAR T-cell therapy eligibility and co-create a framework for rapid patient identification. The experts involved recognized that an effective framework for patient identification should include both clinical and non-clinical factors for eligibility. With a focus on large B cell lymphoma (LBCL), they created the RECUR framework to support rapid identification in community settings and referral to accredited treatment centers.⁸⁵

If they RECUR, you should refer:⁸⁵

1. Relapsed/refractory LBCL: Any person with relapsed or refractory LBCL should be referred for a consult with a CAR T-cell therapy specialist. 
2. Every age and comorbidity: Age and comorbidity should be evaluated on a case-by-case basis by a CAR T-cell therapy specialist                 
3. Caregiver support: Discuss the need for support and continuity continuum of care throughout the patient journey 
4. Urgency to recommend consult: Rapid identification and referral is important for people to undergo timely evaluation for CAR T-cell therapy. 
5. Receive patients returning post-CAR T: Streamline communication across teams within the local network to optimize local care of patient’s local teams to optimize care for people returning after CAR T-cell therapy

Building on the above, the RECUR initiative hosts educational programs, provides resources and acts as a platform for knowledge exchange to support HCPs and patients in navigating CAR T-cell therapy.⁸⁴ It is being disseminated amongst the professional bodies involved to ensure it is adopted as standard.