Operationalizing Seamless Care Between Community and Academic Centers: Turab Mohammed, MD

Why It Matters

Integrating community and academic oncology expands patient access to cutting‑edge immunotherapies, improving outcomes while narrowing socioeconomic disparities; it also accelerates system‑wide adoption of breakthrough treatments.

Key Takeaways

• Care‑navigation teams bridge community and academic referrals.
• Early academic evaluation preserves T‑cell fitness for CAR‑T.
• Trial coordinator shortages limit community trial participation.
• Prior‑auth hurdles delay advanced therapy approvals.
• Education on CRS/ICANS enables community adoption of bispecifics.

Pulse Analysis

Effective care coordination is becoming a linchpin for delivering advanced immunotherapies to patients outside major academic hubs. By establishing dedicated navigation units that manage referrals, payer issues, and real‑time communication, community health systems can ensure that high‑risk leukemia and lymphoma cases are evaluated early at academic centers. This early touchpoint not only secures a "foot in the door" for future CAR‑T eligibility but also preserves the patient’s T‑cell fitness, a critical determinant of response to cell‑based treatments.

Despite these operational gains, community oncology faces persistent structural obstacles. Limited staffing for clinical‑trial coordination hampers enrollment in cutting‑edge studies, while complex prior‑authorization processes slow the adoption of therapies that have yet to appear on NCCN guidelines. Socio‑economic factors—transportation challenges, caregiver availability, and work constraints—further exacerbate disparities, especially for CAR‑T, which traditionally requires intensive inpatient support. Addressing these gaps demands both administrative streamlining and targeted investment in trial infrastructure to democratize access to novel therapies.

Looking ahead, the role of the community hematologist is evolving from a referral conduit to an active treatment provider. Ongoing education—through webinars, CME modules, and in‑person workshops—equips clinicians with the skills to manage cytokine release syndrome and immune‑effector‑cell neurotoxicity, enabling safe administration of bispecific antibodies and, eventually, CAR‑T. As bispecifics demonstrate lower toxicity profiles, they serve as a practical entry point for community practices, paving the way for broader adoption of the most advanced cell therapies across the health‑care continuum.