Early CAR T Cell Therapy Referral: The Missing Piece in Blood Cancer Treatment
Despite significant advances in treatment over the past decade, many patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) may never gain access to innovative treatment options like chimeric antigen receptor (CAR) T cell therapy. Real-world data show that only about 2 in 10 eligible blood cancer patients ultimately receive it—often due to delays in referral, misconceptions about eligibility, or logistical challenges.1 These delays can make the difference between a patient receiving CAR T cell therapy or missing the window for treatment.
Among the available CAR T cell therapies for R/R LBCL, Breyanzi ® (lisocabtagene maraleucel) has shown significant efficacy and established safety outcomes in the Phase 3 TRANSFORM trial, reinforcing its role as a well-established treatment and offering an option for patients with R/R LBCL. Breyanzi is a CD19-directed CAR T cell therapy indicated for adults with refractory disease to first-line chemoimmunotherapy or relapse within 12 months of first-line chemoimmunotherapy. Breyanzi is not indicated for the treatment of patients with primary central nervous system lymphoma. Breyanzi is made from a patient’s own T cells, which are collected and genetically programmed to become CAR T cells that are then delivered via a one-time infusion.2
The treatment process includes leukapheresis, manufacturing, possible bridging therapy, lymphodepletion, administration, and adverse event monitoring. Breyanzi can cause serious life-threatening side effects, such as cytokine release syndrome (CRS), neurologic toxicities (NT), and secondary hematological malignancies.2
Please see the full indication and the Important Safety Information below including Boxed WARNINGs for CRS, NT and secondary hematological malignancies.
The CAR T cell therapy process requires proactive coordination across the care team. Scheduling appointments, arranging potential bridging therapy, and aligning care between community oncologists and CAR T centers are critical steps that ensure patients move efficiently from referral to treatment while they remain eligible for therapy. Even experienced treaters may face practical barriers such as perceived patient frailty, logistical uncertainty, or coordination complexity, which can slow the referral process.
Breyanzi’s consistent manufacturing, well-characterized safety profile, and flexibility for inpatient or select outpatient administration for appropriate patients can help directly address these challenges, enabling clinicians to plan effectively for their patients.2
Beyond timely referral, understanding Breyanzi’s eligibility criteria can help clinicians confidently identify and support appropriate patients. Breyanzi was studied in a broad range of adults with R/R LBCL, and pivotal trials included those with advanced age, comorbidities, or partial responses to prior therapy, addressing common misconceptions about who can receive this therapy. Label updates in June 2025 from the U.S. Food and Drug Administration called for reduced post-infusion monitoring period, reduced post-treatment driving restrictions and removal of the REMS program, making Breyanzi accessible to even more eligible patients.
Its predictable manufacturing process and structured monitoring protocols at CAR T centers further enable care teams to plan treatment effectively and manage potential side effects while supporting patients throughout therapy.
Effective and timely treatment for patients with R/R LBCL is critical as each delay can mean a missed opportunity for durable remission. At a 3-year follow-up, a complete response was seen in 68 out of 92 BREYANZI patients vs. 40 out of 92 patients treated with standard therapy. By combining early CAR T patient identification, proactive communication with CAR T centers, and a clear understanding of the CAR T cell therapy process, clinicians may help support timely access to Breyanzi for appropriate patients.
Tune in as Dr. Nazish Ahmad, Medical Oncologist and Hematologist at Palo Verde Cancer Specialists in Scottsdale, Arizona, shares practical insights on navigating the CAR T cell therapy process for patients with R/R LBCL. For more information about Breyanzi and the referral process, clinicians can visit
BreyanziHCP.com to learn more about therapy considerations, eligibility and next steps.
Speaker: Nazish Ahmad, D.O.
Dr. Ahmad was compensated by Bristol Myers Squibb for participation in this video.