Advanced cancer treatment can cost hundreds of thousands of dollars, requiring days or weeks of monitoring and transportation lodging near large hospitals. But one cancer practice is betting on technology like artificial intelligence chatbots and digital pulse oximeters could dramatically lower costs, eliminate access barriers and help more people overcome the disease.
Until recently, the Center for Cancer and Blood Disorders, a 50-doctor practice in the Dallas-Fort Worth area, referred patients seeking CAR-T, an expensive cell therapy, to academic medical centers that would administer the treatment and then monitor patients in person for risks like neurological complications. (CAR-T, which is typically offered to patients who haven’t responded to standard treatments, uses infusions of patients’ own modified immune cells to target cancer.)
Since January, the practice has begun offering CAR-T to a handful of patients at its own clinics, and partnering with virtual cancer care company Reimagine Care for in-home monitoring. Patients can chat with an AI assistant about issues like nausea and pain, upload vital signs using digitally enabled devices monitored by Reimagine’s own remote oncology team, and when necessary, be connected back to the center’s own staff for follow-up appointments.
Before that partnership, Center for Cancer and Blood Disorders CEO Barry Russo says, “we didn’t feel we could manage the adverse events in a more proactive way,” which “limits the amount of people that can get therapy or get cured.”
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What Is Driving the Changes to CAR-T Therapy?
“We caught (the Texas law) immediately, and realized we have a lot of patients who do not have access” because they live far from academic medical centers or large hospitals, Russo says.
CAR-T is also expensive: Engineering patients’ cells before they’re re-infused can cost hundreds of thousands of dollars. But the right post-infusion monitoring technology would mean “we knew we could do it more cost-effectively,” Russo says.
CCBD was already partnering with Reimagine Care to monitor and communicate with other patients after treatment, paying the company on a per-patient basis. But at the beginning of this year, the two launched a new program to more intensively monitor CCBD’s CAR-T patients.
Tracking the Progress
So far, CCBD has offered CAR-T therapy to four patients, all of whom signed up for Reimagine’s post-treatment monitoring as a condition of treatment. One patient lives an hour outside of Fort Worth, and was unlikely to be able to drive a few hours a day to medical centers in Dallas, where he’d otherwise have had to go to receive CAR-T and the necessary follow-up care.
Another is a single mother in Fort Worth who can’t leave her teenage son behind to get treatment. Two of the four no longer show signs of cancer. CCBD eventually aims to offer the therapy to one patient a month.
“The science is there. These therapies work, but now, it’s delivery and an infrastructure thing,” says Dan Nardi, CEO of Reimagine Care. “How do we bring this to the community to more patients?”
Asked how he’s so sure remote monitoring is as safe as in-hospital monitoring, Russo says there’s “historically been a controversy (about) whether it’s a safe method,” but that early adopters like CCBD are “not having any major adverse events… we’re staying in touch with the patient more often than what may have happened, even if they got their therapy at a hospital setting.”
