Although several chimeric antigen receptor (CAR) T-cell therapies have been available since 2017, only about 20% of eligible patients with treatable hematologic malignancies in the US and European Union receive them. Long-term follow-up from early CAR T studies is increasingly supporting the therapies’ curative potential, prompting efforts to expand access.
A consortium of patient advocates, medical societies, academic and community treatment centers and other experts published the CAR T Vision report in June 2025 with a goal of doubling the number of patients receiving CAR T therapy by 2030. Miguel-Angel Perales, MD, cochair of the CAR T Vision steering committee and chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, called the current statistics unacceptable and described the gap as an ethical problem given the potential for durable remissions.
Barriers to access are multiple. Awareness and understanding of CAR T eligibility remain limited among some community physicians and patients, and misconceptions persist—such as equating transplant ineligibility with CAR T ineligibility. Geographic disparities also restrict access: many patients live three hours or more from a CAR T center, and several US states lack any local center. Insurance issues and referral delays can further prevent timely treatment.
CAR T Vision has convened stakeholders globally to identify practical solutions. The initiative has formed working groups focused on awareness and education, resources and capacity, and financial and reimbursement models. The groups aim to define immediate actions for 2026 and longer-term goals through 2027 and 2028 to increase treatment capacity and streamline care delivery.
Regulatory changes have already reduced some obstacles. Risk Evaluation and Mitigation Strategy (REMS) requirements that previously forced patients to remain near treatment centers for 28 days and refrain from driving for eight weeks have been tightened to focus on clinical safety and reduced to a 14-day intensive monitoring period. Data indicate most cytokine release syndrome and neurotoxicity cases occur within the first two weeks, supporting shorter mandatory monitoring windows and easing logistical burdens for patients and caregivers.
Expanding outpatient CAR T administration and remote monitoring can also improve access and patient outcomes. Outpatient care can preserve mobility and reduce microbiome disruption—factors linked to better recovery—but requires robust infrastructure, overnight emergency support and technology such as wearable monitors. Successful outpatient models depend on center-specific capacity and coordinated regional networks.
CAR T Vision plans to move from problem identification to action in 2026, pursuing partnerships with regulators, policymakers and payers to develop sustainable financing and delivery models. The initiative aims to remove practical, geographic and financial barriers so more eligible patients can benefit from potentially curative CAR T-cell therapies.
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