NCCN Task Force Report: Chimeric Antigen Receptor T-Cell Therapy
Patients with relapsed or refractory (R/R) cancers have a poor prognosis and limited treatment options. The recent approval of 2 chimeric antigen receptor (CAR) autologous T-cell products for R/R B-cell acute lymphoblastic leukemia and non-Hodgkin's lymphoma treatment is setting the stage for what is possible in other diseases. However, there are important factors that must be considered, including patient selection, toxicity management, and costs associated with CAR T-cell therapy. To begin to address these issues, NCCN organized a task force consisting of a multidisciplinary panel of experts in oncology, cancer center administration, and health policy, which met for the first time in March 2018. This report describes the current state of CAR T-cell therapy and future strategies that should be considered as the application of this novel immunotherapy expands and evolves.
This activity is designed to meet the needs of oncologists, hematologists, nurses, pharmacists, physician assistants, and other health care professionals treating patients on CAR T-cell therapy.
Upon completion of this activity, participants will be able to:
- Outline fundamental elements of chimeric antigen receptor (CAR) design and CAR T-cell therapy development
- Summarize key studies using CD19-targeted CAR T-cell therapy in relapsed/refractory B-cell malignancies and their outcomes
- Identify current and emerging management strategies for CAR T-cell therapy-associated toxicities
- Discuss preclinical and clinical strategies being developed for CAR T-cell therapy use in solid tumors
- Summarize recommended considerations for CAR T-cell persistence and disease surveillance
- Outline seminal components required to establish institutional CAR T-cell therapy programs
- Discuss current coverage/reimbursement structures and proposed reimbursement strategies for CAR T-cell therapy
Disclosure of Relevant Financial Relationships
All faculty and activity planners participating in NCCN continuing education activities are expected to disclose any relevant financial relationships with a commercial interest as defined by the ACCME’s, ANCC’s, and ACPE’s Standards for Commercial Support. All faculty presentations have been reviewed for adherence to the ACCME’s Criterion 7: The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2, and 6) by experts on the topics. Full disclosure of faculty relationships will be made prior to the activity.
The NCCN staff listed below discloses no relevant financial relationships:
Kerrin M. Rosenthal, MA; Kimberly Callan, MS; Genevieve Emberger Hartzman, MA; Erin Hesler; Robert W. Carlson, MD; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Karen Kanefield; Lisa G. Kimbro, MBA, CPA (Employed by NCCN until 8/10/18); Rashmi Kumar, PhD; Joan S. McClure, MS (Employed by NCCN until 8/1/18); and Melinda Somasekhar, PhD (Employed by NCCN until 10/30/17)
INDIVIDUALS WHO PROVIDED CONTENT DEVELOPMENT AND/OR AUTHORSHIP ASSISTANCE:
Ndiya Ogba, PhD, Oncology Scientist/Medical Writer, NCCN, has disclosed that she has no relevant financial relationships.
Nicole M. Arwood, PharmD, has disclosed that she has no relevant financial relationships.
Nancy L. Bartlett, MD, has disclosed that she has no relevant financial relationships.
Mara Bloom, JD, has disclosed that she has no relevant financial relationships.
Patrick Brown, MD, has disclosed that he has received consulting fees/honoraria from Amgen, Inc., Novartis Pharmaceuticals Corporation, and Shire Pharmaceuticals.
Christine Brown, MD, has disclosed that she has received consulting fees/honoraria, grant/research support, royalty income from and serves as a scientific advisor for Mustang Bio, Inc. She also has equity interest/stock options in Mustang Bio Inc., and Xencor Inc.
Elizabeth Lihua Budde, MD, has disclosed that she is a scientific advisor for Precision Bioscience, and is a consultant for Kite Pharma.
Robert Carlson, MD, Chief Executive Officer, NCCN, has disclosed that he has no relevant financial relationships.
Stephanie Farnia, MPH, has disclosed that she has no relevant financial relationships.
Terry Fry, MD, has disclosed that he has no relevant financial relationships.
Morgan Garber, MSW, has disclosed that she has no relevant financial relationships.
Rebecca Gardner, MD, has disclosed that she has received consulting fees/honoraria from Novartis Pharmaceuticals Corporation.
Lauren Gurschick, NP, has disclosed that she has served as a scientific advisor for Celgene Corporation.
Patricia Kropf, MD, has disclosed that she has received consulting fees/honoraria from Celgene Corporation, and Takeda Pharmaceuticals North America, Inc. She is also on the product/speakers bureau for Takeda Pharmaceuticals North America, Inc.
Jeff J. Reitan, MA, has disclosed that he has no relevant financial relationships.
Craig Sauter, MD, has disclosed that he has received consulting fees/honoraria from Juno Therapeutics, Inc., Novartis Pharmaceuticals Corporation, and sanofi-aventis U.S. LLC. He has also received grant/research support from Juno Therapeutics, Inc., and sanofi-aventis U.S. LLC.
Bijal Shah, MD, has disclosed that he has received consulting fees/honoraria from Pharmacyclics, Inc., and is on the product/speakers bureau for Amgen, Inc. He has also received grant/research support from Incyte Corporation.
Elizabeth Shpall, MD, has disclosed that she has no relevant financial relationships.
Steven T. Rosen, MD, Task Force Chair, has disclosed that he has no relevant financial relationships.
The ACCME/ANCC/ACPE defines “conflict of interest” as when an individual has an opportunity to affect CE content about products or services of a commercial interest with which he/she has a financial relationship.
ACCME, ACPE, and ANCC focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CE activity. ACCME, ACPE, and ANCC have not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME, ACPE, and ANCC defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation to the tasks and methods of delivery.
National Comprehensive Cancer Network is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
NCCN designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
National Comprehensive Cancer Network is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
NCCN designates this educational activity for a maximum of 1.0 contact hour.
|National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.|
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.1 CEUs) of continuing education credit. UAN: 0836-0000-18-102-H01-P
All clinicians completing this activity will be issued a certificate of participation.
- 1.00 ACPE contact hours
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC contact hours
- 1.00 Participation