Four emergent themes
| Criteria . | Working definition . |
|---|---|
| Medical benefit | Whether the intent of the therapy has curative potential or if it will significantly prolong life; consideration of predictors of poor response or survival; whether any alternative treatment options are available (including trials) |
| Safety/risk of complications | Consider the clinical risks of receiving CAR-T, including patient predictors of toxicity; is the patient healthy enough overall to withstand treatment (eg, organ function, comorbidities, frailty, and performance status) |
| Psychosocial factors | No history of noncompliance or lack of adherence to therapy that would affect quality of care; no financial concerns; no dependents of which patient is primary caregiver or does not have a secondary caregiver for the treatment period; adequate health literacy with or without supports; speaks English or has access to a translator; no untreated psychiatric or coping concerns; no serious, untreated mental illness; no untreated substance use disorder; patient and family have reasonable expectations of therapy and outcomes |
| Medical urgency | Consider disease characteristics that dictate urgency (eg, aggressive pace of disease, refractory to last line, and development of critical complications). Where all else is equal, a patient waiting longer should receive access first. Consider first come, first service if all else is equal. |
| Criteria . | Working definition . |
|---|---|
| Medical benefit | Whether the intent of the therapy has curative potential or if it will significantly prolong life; consideration of predictors of poor response or survival; whether any alternative treatment options are available (including trials) |
| Safety/risk of complications | Consider the clinical risks of receiving CAR-T, including patient predictors of toxicity; is the patient healthy enough overall to withstand treatment (eg, organ function, comorbidities, frailty, and performance status) |
| Psychosocial factors | No history of noncompliance or lack of adherence to therapy that would affect quality of care; no financial concerns; no dependents of which patient is primary caregiver or does not have a secondary caregiver for the treatment period; adequate health literacy with or without supports; speaks English or has access to a translator; no untreated psychiatric or coping concerns; no serious, untreated mental illness; no untreated substance use disorder; patient and family have reasonable expectations of therapy and outcomes |
| Medical urgency | Consider disease characteristics that dictate urgency (eg, aggressive pace of disease, refractory to last line, and development of critical complications). Where all else is equal, a patient waiting longer should receive access first. Consider first come, first service if all else is equal. |