The accelerated approvals of Kymriah (Novartis) for the treatment of children and young adults with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL) and Yescarta (Kite Pharma, a Gilead company) for relapsed/refractory large B-cell lymphoma herald a new era in cancer immunotherapy. In this series of reports, we present a comprehensive analysis of current and emerging chimeric antigen receptor (CAR) T-cell therapies. We examine the CAR T-cell treatment landscape: the technology behind it, ongoing clinical development, the challenges, pricing and market access, physicians’ views, and future opportunities for this paradigm-shifting treatment approach.


  • How is CAR T-cell therapy being adopted into medical practice? What kind of referral patterns are in place for potentially eligible patients? What is the typical patient journey for a patient receiving CAR T-cell therapy?
  • What kind of support and training programs for Kymriah and Yescarta are in place for healthcare professionals, patients, and caregivers?
  • What are the key pricing, access, and reimbursement issues facing Kymriah and Yescarta? What novel reimbursement strategies are marketers implementing to ensure market access?
  • What challenges remain and could limit widespread and maximum adoption of autologous CD19-targeted CAR T-cell therapies? What are the future directions and opportunities?
  • What are the notable developments in the pipeline? Who are the key players, and what novel targets are they exploring?


Special Topics Report Series: Is a three-wave series based on KOL interviews conducted at about one, six, and twelve months postcommercialization and on secondary data collected from a variety of sources. We capture physicians’ awareness, perception, and use of the launched product and anticipated future trends.

Markets covered: United States

Primary research: Qualitative interviews with ten U.S. hematologist-oncologists and thought leaders for the three waves.

Key metrics included:

  • Physician familiarity with and impressions of Kymriah, Yescarta, and other CAR T-cell therapies in the pipeline.
  • Referral patterns, patient journey, and certification of treatment centers.
  • Current manufacturing and scalability challenges.
  • Marketing and educational programs for patients, healthcare professionals, and caregivers.
  • Cost of CAR T-cell therapy and novel pricing and market access strategies.

Table of contents

  • Chimeric Antigen Receptor (CAR) T-Cell Therapy - Emerging Therapies - Chimeric Antigen (CAR) T-Cell Therapy - Special Topics - US (Wave 2)
    • Executive Summary
      • Summary of Kymriah vs. Yescarta
      • Expert Insight
    • The CAR T-Cell Therapy Paradigm
      • Engineering Autologous T-Cell Therapy
      • Expert Insights on CAR T-Cell Technology
    • Kymriah (Tisagenlecleucel-T)
      • Timeline for Administration of Kymriah Therapy for B-Cell ALL
      • Results from Key Clinical Trials of Kymriah in the Treatment of B-Cell ALL and DLBCL
      • Expert Insights on Kymriah
      • Patient Journey and Referral Patterns for Kymriah Therapy for B-Cell ALL Patients
      • Expert Insights on the Patient Journey and Referral Patterns for Kymriah
      • Support and Training Programs for Kymriah
      • Expert Insights on the Support and Training Programs for Kymriah
      • Pricing, Access, and Reimbursement for Kymriah
      • Expert Insights on Pricing, Access, and Reimbursement for Kymriah
      • Ongoing Clinical Development of Kymriah
      • Key Ongoing Clinical Trials of Kymriah
    • Yescarta (Axicabtagene Ciloleucel)
      • Timeline for Administration of Yescarta Therapy for Large B-Cell Lymphoma
      • Results of Key Clinical Trials Investigating Yescarta for the Treatment of NHL
      • Expert Insights on Yescarta
      • Support and Training Programs for Yescarta
      • Expert Insights on the Support and Training Programs for Yescarta
      • Pricing, Access, and Reimbursement for Yescarta
      • Expert Insights on Pricing, Access, and Reimbursement for Yescarta
      • Ongoing Clinical Development of Yescarta
      • Key Ongoing Clinical Trials of Yescarta
      • Choosing Between Kymriah and Yescarta
        • Physicians’ Choice Between Kymriah and Yescarta
        • Choosing Between Kymriah and Yescarta for Adult Patients with Large B-Cell Lymphoma
    • CAR T-Cell Therapy Pipeline
      • Notable Developments in the Pipeline
      • CAR T-Cell Therapies in Clinical Development
      • Expert Insights on the CAR T-Cell Pipeline
    • Challenges and Future Directions
      • Challenges Facing Current CD19-Targeted CAR T-Cell Therapies
      • Future Directions and Opportunities for CAR T-Cell Therapies
      • Expert Insight on the Challenges and Future Directions of CAR T-Cell Therapy
    • Methodology
      • Primary Market Research
      • Appendix
        • Key Abbreviations Related to CAR T-Cell Therapy
        • CAR T-Cell Therapy Bibliography

    Author(s): Anamika Ghosh, Ph.D.; Rachel Webster

    Anamika Ghosh, Ph.D.,is a Senior Analyst for the oncology team at Decision Resources.

    Prior to joining DRG, Anamika was a Research Lead with Evalueserve Pvt. Ltd., a business solutions provider to pharmaceutical companies. At Evalueserve, she worked on various strategic insights solutions for a variety of indications, including oncology, cardiovascular, ophthalmology etc. Anamika holds a PhD on host-pathogen interactions in the context of M. tuberculosis from the International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India, where she also worked as a Research Associate working on Dengue viral infection.

    Rachel Webster M.Sc., D.Phil., is a senior director in the oncology and biosimilars team at Decision Resources Group, where she manages a team of analysts in producing syndicated primary and secondary market research reports on a wide range of oncology indications. She also provides sales and client support for all oncology products.

    Previously, Dr. Webster was a senior analyst in the oncology group at Decision Resources. Dr. Webster has extensive experience in market forecasting with detailed expertise in cancer immunotherapies, prostate cancer, gastric cancer, and malignant melanoma. Dr Webster is also experienced in conducting primary research with physicians and payers in a wide range of oncology indications across the major pharmaceutical markets. Prior to joining Decision Resources Group, Dr. Webster was a research scientist at Immunocore in the target validation group, where her research focused on identifying target antigens expressed in cancers and autoimmune diseases using a proprietary T-cell receptor (TCR) technology platform, molecular biology and phage display techniques. Dr. Webster obtained her D.Phil., in biochemistry, M.Sc. and M.A (Hons) in biological sciences, from the University of Oxford.