Episode # 78 • 25 Aug 2026
Developing CAR T-cell Programs in Community Oncology
with Dr. Mike Byrne, Aaron Lyss
Where does access to cell therapy actually break down, and can community practices close the gap? On this episode of BackTable Tumor Board, host Aaron Lyss interviews Dr. Mike Byrne, a hematologist at Tennessee Oncology, about the challenges and successes of building an outpatient CAR T program in the community setting. They discuss the critical stakeholder relationships, operational and financial structures, and patient pathways that enable a physician-owned practice to offer cellular therapy outside a hospital system.
Timestamps
00:00 - Introduction
03:50 - What Community Oncology Actually Means Here
08:15 - Speed as the Differentiator: One EMR, No Repeat Workup
10:40 - Look Before You Leap: Pipeline and Standard-of-Care Shifts
17:30 - Why Cell Therapy Sits Outside Existing Payer Contracts
20:35 - Pre-Treatment Evaluation, Insurance Vetting, and FACT Accreditation
26:10 - Adding a BCMA CAR T
30:30 - Infusion Day Logistics
35:20 - Outpatient Monitoring Without a Six-Figure Platform
39:00 - Co-Managing With the Referring Oncologist
46:00 - Wrap Up and Closing Remarks
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More about this episode
The conversation details how the Tennessee Oncology team aligned hospital, apheresis, and manufacturer partnerships, navigated payer arrangements outside traditional contracts, and streamlined workflows for rapid referral, insurance vetting, scheduling, and just-in-time cell shipping. The conversation explores practical decisions about when to build versus outsource services, the need for a robust patient pipeline amid shifting standards of care, and the risk management required to deliver high-cost therapies. Dr. Byrne shares how the program prioritizes access, leverages telehealth for monitoring, empowers advanced practice providers for overnight care, and adapts quickly for unique patient needs. The episode closes with real-world stories of patients who benefited from flexible, community-based care.
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