Ep. 80 Scaling Community CAR-T: Operational Lessons and Future Directions with Dr. Mike Byrne

How does delivering CAR-T in the community change patient care, and what has to happen next for these programs to scale? On this episode of the BackTable Tumor Board Podcast, host Aaron Lyss interviews Dr. Mike Byrne, hematologist at Tennessee Oncology and medical director for cellular therapy at OneOncology, about operational lessons and future directions for outpatient CAR-T therapy. They discuss the impact of faster time to treatment, building trust through local relationships, and the weekly pipeline management that keeps the program moving. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:21 - Patient Impact and Access to Therapy 04:42 - Reducing Friction in the Referral Pathway 07:50 - Expectations Versus Reality in Program Development 10:35 - Managing the Weekly Patient Pipeline 13:08 - Priorities for the Next Generation of CAR T 16:14 - Iterating on CD19 Constructs and Manufacturing 19:07 - Safety Profiles and Care Delivery Models 23:54 - Cellular Therapy in Autoimmune Disease 27:47 - Allogeneic and In Vivo CAR T 32:09 - Wrap Up and Closing Remarks --- More about this episode Dr. Byrne describes two groups the program has reached: patients with rapidly progressing disease who could not withstand referral delays, and patients with low health literacy who followed treatment recommendations from their local oncologist. He describes operational changes that reduced vein-to-vein time to about a third of published figures and enabled the program to function independently of any single individual. The conversation then shifts to the future of cell therapy, covering innovations such as dual-targeting CD19 and CD20 constructs with a 4-1BB arm and shorter manufacturing times, the safety thresholds community oncology will use to select new products, early developments in autoimmune disease and the potential need for rheumatology partnerships, and whether allogeneic and in vivo CAR-T can reach patients in what Dr. Byrne calls cell therapy deserts. The episode closes by addressing ongoing challenges in access, evolving institutional partnerships, and the need for mature data as CAR-T therapy expands across new settings. --- Resources KITE-363 and KITE-753 in relapsed or refractory B-cell lymphoma, the dual targeting CD19 and CD20 CAR T program https://clinicaltrials.gov/study/NCT04989803 KITE-363 in refractory autoimmune disease, the autoimmune arm of the same construct https://clinicaltrials.gov/study/NCT07038447 iMMagine-1, pivotal study of anitocabtagene autoleucel, the BCMA CAR T with a December FDA decision date https://clinicaltrials.gov/study/NCT05396885 First in human data for in vivo CAR T in multiple myeloma, presented at the ASH annual meeting https://ascopost.com/issues/february-25-2026-supplement-ash-meeting-highlights-2025/early-findings-from-first-human-study-of-in-vivo-car-t-in-myeloma/ In vivo CAR T cell therapy, review of the 2025 ASH annual meeting updates https://pubmed.ncbi.nlm.nih.gov/41957634/ American Society of Hematology Annual Meeting https://www.hematology.org/meetings/annual-meeting Michael T. Byrne, DO, FACP, physician profile at Tennessee Oncology https://tnoncology.com/physicians/michael-t-byrne-m-d/ OneOncology appoints Dr. Michael Byrne as Medical Director for Cellular Therapy https://www.oneoncology.com/blog/oneoncology-appoints-dr-michael-byrne-as-medical-director-for-cellular-therapy/ Aaron Lyss on the administrative demands of bringing CAR T into community practice https://www.ajmc.com/view/taking-the-giant-leap-into-car-t-managing-financial-and-administrative-challenges --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app