Taking CAR-T Outpatient: A Clinical Pharmacy Perspective

In this episode of ASTCT Talks, host Terri Lynn Shigle, PharmD, BCOP, clinical pharmacy specialist with Stem Cell Transplantation and Cellular Therapy Department at The University of Texas MD Anderson Cancer Center and current ASTCT director of pharmacists (ex-officio), is joined by Erin Eberwein, PharmD, CPP, BCOP, clinical pharmacist practitioner for ambulatory setting with Stem Cell Transplant and Cellular Therapy at Duke University Hospital, and Cameron Ninos, PharmD, BCOP, cellular therapy clinical pharmacist at UW Health, to discuss the growing shift of CAR T therapy from the inpatient setting to outpatient.

As advances in toxicity prediction, remote patient monitoring, and clinical guidance make outpatient cellular therapy increasingly feasible, centers are developing new models of care to safely administer CAR T therapy while improving patient access and experience. Drawing on their frontline experience, Drs. Eberwein and Ninos share practical approaches to building, managing, and optimizing outpatient CAR T programs.

The discussion covers:

• Building and operating an outpatient CAR T clinic, including patient selection, multidisciplinary team structure, and after-hours support.
• Outpatient monitoring and management of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), including remote monitoring technologies, caregiver education, and admission criteria.
• Key pharmacy considerations, including lymphodepletion dosing, supportive care strategies, growth factor use, and the expanding role of the clinical pharmacy specialist in outpatient cellular therapy.

This episode provides practical insights for clinicians, pharmacists, and cellular therapy programs seeking to expand outpatient CAR T delivery while maintaining safety, coordination, and high-quality patient care.

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This episode was made possible through support from Johnson & Johnson.