Barriers to Patient Referral and Completion of CAR T-Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy has improved outcomes for patients with hematologic malignancies such as relapsed or refractory large B-cell lymphoma. However, research indicates that a substantial proportion of medically eligible patients with relapsed or refractory large B-cell lymphoma in the United States do not receive CAR T-cell therapy. Multiple barriers across the treatment pathway contribute to the significant gap between patient eligibility and receiving treatment. To further examine these barriers, a multistakeholder panel was convened on October 8, 2025. Key barriers identified included limited patient awareness of CAR T-cell therapy, inadequate knowledge and application of eligibility criteria, logistical and financial burdens, and delays resulting from health system processes. The panel members identified potential ways to improve treatment access and completion, including expanding treatment sites capable of delivering CAR T-cell therapy in community settings and shifting supportive resources (financial counselors, social workers, patient navigators) from treatment centers to community oncology practices.