Improving CAR T-cell therapy access: Insights from a survey of US-based oncology professionals.

153 Background: CAR T-cell therapy (CAR T) offers patients with hematologic malignancies the potential for durable remission and improved survival; however, access challenges remain due to multifactorial barriers impacting timely patient referral and evaluation. To identify opportunities for improvement, the Association of Cancer Care Centers (ACCC) surveyed multidisciplinary oncology professionals across the US. Methods: ACCC designed an online survey, with input from an expert task force, for multidisciplinary professionals involved in the care or oversight of adults with hematologic malignancies. The survey was distributed in April 2025. Basic frequencies were generated. Mean scores were calculated for ranking questions. Crosstabs compared outcomes by programs’ CAR T availability and region. Tests included Pearson’s chi-square, Fisher’s exact test, t-tests, ANOVA, and Tukey’s post-hoc pairwise comparisons. Results: Of 136 respondents, 57% worked at authorized treatment centers (ATCs) and 43% at non-ATCs. 37 states were represented, which included the south (40%), midwest (29%), west (18%), and northeast (18%) regions. The majority (81%) indicated patients who receive CAR T have better outcomes than those who are eligible but do not. The highest impact facilitator for timely referral among all respondents was transportation/lodging assistance (79%). Reflecting the need to reduce patient travel burden, the top-ranked infrastructure/capacity changes to improve access were: 1) expanding outpatient administration (2.54), 2) increasing program availability closer to where patients live (2.51), and 3) enabling remote monitoring for earlier discharge/follow-up (2.36). Significant regional differences emerged when comparing ATC and non-ATC perspectives. In the south (p = 0.0357) and west (p = 0.0440), ATCs more often supported referring program involvement in pre-treatment activities such as leukapheresis and bridging therapy. In the midwest, ATCs placed a higher priority on referring provider training/education (p = 0.0023). Conclusions: Oncology professionals widely recognize the clinical value of CAR T and the need for targeted infrastructure to facilitate timely access. While overall priorities are aligned, regional and program-level differences—particularly in pre-treatment roles and education needs—suggest variability in care delivery models and readiness, warranting further exploration. These insights can inform tailored, region-specific quality improvement initiatives.