COMy 2025 | Safety and feasibility of outpatient CAR-T programs and the real-world experience with cilta-cel

At this current point in time, cilta-cel is very well poised to become an outpatient CAR because the median time to CRS and ICANS is about a week. So these patients can be given low-dose chemo, outpatients can have an infusion outpatient, and if the program is not well equipped with the resources to manage completely these things as an outpatient, you can electively admit this patient after day four or five. So that whole infusion and the low-dose chemo part can be given outpatient. But beyond that point, if you want to manage everything outpatient, then you definitely need the resources in place. So a program like ours, where we have enough resources, what does it mean to have enough resources? That means if the patients can be managed for CRS and ICANS completely as an outpatient, if there is a strategy for that, then this can be done as an outpatient. For us, we do all commercial CAR-T as an outpatient, and the patient who gets CRS after hours can be managed in our 24-hour clinic with the tocilizumab, with the dexamethasone if needed, and if the patient needs admission or not based on the criteria that we have developed. So I think, you know, most of the programs are already doing the outpatient CAR-T and I think this kind of model is probably going to be implemented or can be translated into other centers as well. But I think the bottom line is you need to have the right resources, the right people, and the right protocols in place to have that happen.

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