A hub-and-spoke model to deliver effective access to chimeric antigen receptor T-cell therapy in a public health network: the Catalan Blood and Tissue Bank experience

• Published in: Cytotherapy (Oxford, England) Vol. 25; no. 1; pp. 14 - 19
• Main Authors: Fernandez-Sojo, Jesus, Delgadillo, Joaquim, Vives, Joaquim, Rodriguez, Luciano, Mendoza, Ana, Azqueta, Carmen, Garcia-Buendia, Ana, Valdivia, Elena, Martorell, Lluis, Rubio-Lopez, Nuria, Linares, Mónica, Alonso, Sofia, Ancochea, Agueda, García-Rey, Enric, García-Muñoz, Nadia, Medina, Laura, Querol, Sergio
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.01.2023
• Subjects: Academic hospitals; CAR T cells; Hematopoietic Stem Cell Transplantation; Hub-and-spoke; Humans; Immunotherapy, Adoptive - methods; Medicine warehouse; Network; Public Health; Receptors, Antigen, T-Cell; Receptors, Chimeric Antigen; Retrospective Studies; CAR T cells; Medicine warehouse; Academic hospitals; Network; Hub-and-spoke
• ISSN: 1465-3249; 1477-2566
• DOI: 10.1016/j.jcyt.2022.07.011

To describe and analyze whether a hub-and-spoke organizational model could efficiently provide access to chimeric antigen receptor (CAR) T-cell therapy within a network of academic hospitals and address the growing demands of this complex and specialized activity. The authors performed a retrospective evaluation of activity within the Catalan Blood and Tissue Bank network, which was established for hematopoietic stem cell transplantation to serve six CAR T-cell programs in academic hospitals of the Catalan Health Service. Procedures at six hospitals were followed from 2016 to 2021. Collection shipments of starting materials, CAR T-cell returns for storage and infusions for either clinical trials or commercial use were evaluated. A total of 348 leukocytapheresis procedures were performed, 39% of which were delivered fresh and 61% of which were cryopreserved. The network was linked to seven advanced therapy medicinal product manufacturers. After production, 313 CAR T-cell products were shipped back to the central cryogenic medicine warehouse located in the hub. Of the units received, 90% were eventually administered to patients. A total of 281 patients were treated during this period, 45% in clinical trials and the rest with commercially available CAR T-cell therapies. A hub-and-spoke organizational model based on an existing hematopoietic stem cell transplantation program is efficient in incorporating CAR T-cell therapy into a public health hospital network. Rapid access and support of growing activity enabled 281 patients to receive CAR T cells during the study period.