Title: Establishing the first Victorian regional CAR T-Cell therapy service and a specialised nurse project lead at Barwon Health
Background: Chimeric Antigen Receptor T-cell therapy (CAR-T) is a complex and resource intensive treatment requiring clinical expertise and coordinated multidisciplinary care. Access to CAR-T therapy in regional settings is limited by workforce capability, infrastructure, and service coordination challenges. Establishing regional delivery models is critical to improving equitable access.
Aims: To describe the establishment of a regional CAR-T program at Barwon Health, enabling participation in clinical trials and coordination of standard of care therapy closer to home.
Methods: A dedicated CAR-T nurse project lead was appointed, supported by a multidisciplinary working group. An external gap analysis informed a targeted implementation strategy focused on clinical readiness, workforce capability, toxicity management, and cold-chain governance.
Results: The program has successfully established the infrastructure and clinical governance required to initiate CAR-T therapy in a regional setting. Key achievements include implementation of evidence-based policies, workforce education, and a supernumerary training partnership with a metropolitan tertiary centre to address experiential gaps. These initiatives have enabled activation of the first CAR-T clinical trial at BH, with two patients treated to date. Two additional cellular therapy trials are scheduled to open. A nurse-led CAR-T follow-up clinic has been established, facilitating early discharge and ongoing management in the regional setting, directly supporting delivery of care closer to home.
Conclusion: A dedicated nurse project lead and coordinated multidisciplinary approach have rapidly translated capability into clinical trial activation in a regional health service. Expansion of this model has the potential to significantly improve access to CAR-T therapy for regional populations.