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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1466803
How to optimize the CAR-T Cell therapy process? A Group Concept Mapping Analysis of preconditions for a frictionless process from a German multistakeholder perspective
Provisionally accepted- 1 Faculty of Medicine, University of Duisburg-Essen, Duisburg, North Rhine-Westphalia, Germany
- 2 VITIS Healthcare Group, Cologne, Germany
- 3 Department of Hematology and Stem Cell Transplantation, Faculty of Medicine and University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- 4 Department of Hematology and Stem Cell Transplantation, West German Cancer Center and German Cancer consortium (DKTK partner site Essen), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- 5 Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- 6 Department of Hematology, Giessen & Marburg University Hospital, Giessen, Germany
- 7 Department of Hematology/Oncology and Stem-cell transplantation, St Georg, Asklepios Hamburg, Hamburg, Germany
- 8 Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
- 9 Department of Hematology and Medical Oncology, Division for stem cell transplantation and cellular therapy, University Hospital Göttingen, Goettingen, Germany
- 10 Department of Internal Medicine III, Klinikum Chemnitz, Chemnitz, Germany
- 11 FOM University of Applied Sciences for Economics and Management, Essen, North Rhine-Westphalia, Germany
Introduction: Treatment with chimeric antigen receptor T (CAR-T) cells involves a large number of interdisciplinary stakeholders and is associated with complex processes ranging from patient-specific production to follow-up care. Due to the complexity, maximum process optimization is required in order to avoid efficiency losses. This study aimed at systematically determining the preconditions for a frictionless flow of the CAR-T process by surveying the stakeholders involved.Methods: A Group Concept Mapping (GCM) analysis, a mixed-methods participatory research, was conducted. CAR-T experts from different professional backgrounds went through three steps: 1) Brainstorming relevant aspects (statements) for a frictionless process, 2) Sorting the collected statements based on their similarity, and 3) Rating the importance and feasibility of each statement. A cluster map reflecting the overarching topics was derived, and mean ratings per statement and cluster were calculated.Results: Overall, 20 CAR-T experts participated. A total of 80 statements were collected, resulting in a map of the following 10 clusters (mean importance/feasibility): Information for patients and physicians (4.16/3.77), Supportive network (4.03/3.53), Eligibility of patients (4.41/3.63), Evidence, transparency and communication (4.01/3.33), Paperwork (4.1/2.52), Interface with pharmaceutical manufacturer (4.03/2.85), Reimbursement (4.29/2.31), Quality Management (4.17/3.18), Infrastructure of CAR-T clinics (4.1/2.93), and Patient-oriented processes (4.46/3.32).Discussion: The 80 statements underlined the complex and manifold nature of the CAR-T treatment process. Our results reflect the first step in overcoming hurdles: identifying potential hurdles and required preconditions. Decision-makers and stakeholders can use the results to derive strategies and measures to further promote a frictionless process.
Keywords: car-t, Hematology, cluster map, mixed-methods, barriers, Process optimization, Group concept mapping
Received: 18 Jul 2024; Accepted: 28 Aug 2024.
Copyright: © 2024 Siefen, Kurte, Jakobs, Teichert, Von Tresckow, Reinhardt, Holtick, Atta, Jehn, Sala, Warnecke, Hänel, Scheid and Kron. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Florian Kron, VITIS Healthcare Group, Cologne, Germany
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