Join Drs. Caimi and Sdrimas for a focused discussion on the coordination of CAR-T therapy between academic and community practices. As CAR-T use expands, ensuring seamless communication and shared responsibilities between care teams is essential. Using a real-world patient case, this episode explores how to navigate logistics, manage toxicities, and support patients in both settings—delivering collaborative, high-quality care.

Learning Objectives:

1. Understand the shared roles and responsibilities in CAR-T patient management across care settings

2. Identify communication strategies that support safe and effective care coordination

3. Explore real-world barriers and solutions to bridging academic and community practice collaboration

Clinical Pearls:

1. Early and Appropriate Referral is Crucial:
   • Community oncologists should refer patients early in the disease course. Being ineligible for transplant does not mean a patient is ineligible for CAR-T. Timely referral (i.e. before any other therapy is started unless clinically needed) allows for proper evaluation, manufacturing logistics, and bridging therapy if needed.
2. Clear, Bidirectional Communication is Key to Safe Co-management: Successful shared care relies on:
   • Identified point persons at both the academic and community sites (often including nurse coordinators).
   • Timely updates about treatment timelines and toxicity events. Ideally, same day if a toxicity occurs. Weekly updates for treatment timelines.
   • Use of standardized handoff templates and direct lines of communication to ensure continuity, safety, and efficiency in post-infusion monitoring.
3. Empowering the Community Practice Enhances Access and Outcomes:
   • Academic CAR-T centers, hematologists, nursing staff, and CAR-T coordinators educating community providers on late toxicities, infection risks, and long-term monitoring enables safe local care.

Helpful resources:

https://ashpublications.org/blood/article/141/20/2405/494965/Introduction-to-a-How-I-Treat-series-on-emergent
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00094-9/abstract
https://www.astct.org/Education/Practice-Guidelines

Join us for an insightful discussion with Drs. Natalia Neparidze and Saad Z. Usmani as we explore treatment strategies for relapsed multiple myeloma following BCMA-targeted therapy failure. With CAR T-cell therapy and bispecific antibodies revolutionizing myeloma treatment, clinicians are now faced with new challenges as patients relapse after BCMA-directed therapies.

Through the case of a 62-year-old woman who relapsed one year post-BCMA CAR T-cell therapy, we will discuss mechanisms of resistance, treatment sequencing, and the role of novel agents like selinexor-pomalidomide-dexamethasone. This episode will provide hematologists with practical strategies to navigate post-BCMA treatment failure and optimize patient outcomes.

Learning Objectives

1. Understand mechanisms of resistance and progression following BCMA-targeted therapy.
2. Explore non-BCMA treatment options, including alternative targets and novel agents.
3. Recognize key factors influencing treatment selection and patient management.

Join us for an insightful discussion on hereditary hemorrhagic telangiectasia (HHT) with Drs. Hanny Al-Samkari and Adrienne Hammill as we explore the challenges in diagnosing and managing this genetic disorder. HHT is characterized by the development of bleeding nasal and gastrointestinal telangiectasias, as well as arteriovenous malformations (AVMs) in visceral organs and the central nervous system. Patients with HHT almost universally experience recurrent, often severe nose bleeding, and commonly develop gastrointestinal bleeding and complications of AVMs in the lung, liver, and/or brain. Through the case of a 40-year-old woman with recurrent bleeding episodes, we will explore the clinical features, diagnostic workup, and treatment options for HHT. This episode will provide valuable, evidence-based insights into how to approach the diagnosis and management of patients with HHT to improve outcomes and prevent complications.

Learning Objectives:

1. Identify the hallmark clinical features and diagnostic criteria for hereditary hemorrhagic telangiectasia (HHT).
2. Explain the role of imaging and genetic testing in diagnosing HHT and assessing vascular malformations.
3. Discuss management strategies, including proper pharmacologic management of chronic epistaxis and gastrointestinal bleeding, proper management of anemia, and management of AVMs.