Lessons Learned: Operationalizing Chimeric Antigen Receptor T-Cell Therapy in the Community Oncology Private Practice...

Chimeric antigen receptor (CAR) T-cell therapy is an established therapy for relapsed or refractory hematologic malignancies. Traditionally, it has been administered in outpatient or inpatient settings at urban academic medical centers that are affiliated with established stem cell transplantation programs. Tennessee Oncology has successfully treated more than 30 patients with CAR T-cell therapy since August 2024 in the community oncology outpatient setting.

This article reviews key discoveries and lessons learned in creating a cellular therapy program in a nontraditional setting. Tennessee Oncology approached this endeavor with confidence, not fully understanding the complexity of transitioning from concept to care for the first patient.

Oncology nurses across several roles collaborated, planned, developed, implemented, and educated staff about CAR T-cell therapy across 24 months. The first 12 months were spent without a patient in the program, to assist other facilities in operationalizing their first CAR T-cell therapy program.

Building an institutional CAR T-cell therapy program from inception is a resource-intensive and iterative process; however, successful execution can be achieved through unwavering stakeholder investment and a highly skilled specialized nursing workforce.