Systematic Literature Review of Characteristics Associated with Safety and Healthcare Resource Utilization Outcomes in Various Settings of Care for Chimeric Antigen Receptor T-cell Therapy

Access to CAR T has been limited by the number of authorized treatment centers (ATC), the majority being academic centers in large urban areas. Recent efforts to expand access have led to the development of shared care models (SCM) where community sites co-manage patients receiving CAR T in collaboration with an ATC. To achieve desired outcomes while maintaining safety, it is essential to understand optimal patient-relevant characteristics for SCMs. We conducted a systematic literature review (SLR) to identify characteristics associated with short-term (≤ 6 months) safety and HCRU outcomes for patients with DLBCL receiving FDA-approved CAR T therapies. EMBASE and Medline databases were searched from 1/1/17 – 8/2/25 using terms related to CAR Ts, patient characteristics, treatment management options, safety, and HCRU. Findings were categorized into patient/disease characteristics and treatment management options. Studies were excluded if published before 2020, enrolled <100 patients, or included a population with < 70% diagnosed with DLBCL. The SLR preliminary findings are as follows: 4,907 records were screened; 44 studies met inclusion criteria. Most studies were RWE (93%) and US-based (71%). Safety outcomes were reported in 98% of studies, most commonly ICANS (77%) and CRS (75%), while HCRU outcomes were less frequently reported (21%). Most common characteristics assessed for associations were patient (84%), disease (41%), then treatment management options (32%). Among patient characteristics, the top five were inflammatory lab values (eg, lactate dehydrogenase, C-reactive protein, ferritin; 48%), comorbidities (34%), age (32%), Eastern Cooperative Oncology Group performance status (23%) and sex (21%). The top five disease characteristics were tumor burden, extranodal involvement, and bulky mass (each 11%), disease status (9%), and Ann Arbor stage (9%), while treatment management options included bridging therapies (18%) lymphodepletion therapies (14%), prophylactic therapy, hematopoietic stem cell transplant (SCT), and autologous SCT (each 5%). Associations between characteristics and outcomes of interest will be reported at the time of presentation. Early findings of this SLR identified several patient/disease characteristics and treatment management options that have been evaluated for associations with safety and HCRU outcomes. Lab values and baseline comorbidities were the most frequently examined characteristics. Understanding the factors influencing toxicity/HCRU outcomes can help physicians effectively co-manage patients receiving CAR T across diverse care settings. Effective implementation of CAR T SCMs will depend on standardized approaches to patient characterization, ensuring optimal selection, appropriate management, and broader integration of CAR T into community practice.