OBJECTIVES : Chimeric antigen receptor (CAR) T cell therapy is indicated for the treatment of hematological malignancies. The use of CAR T cells is an issue of high interest considering that the number of completed and ongoing trials in 2019 was 94. In addition, the cost of these therapies is higher than 350,000 US$ and the supply chain cost represents approximately 30% of the total cost of treatment. The objective of this review is to analyse CAR Tcell therapy supply chain management and to identify related challenges and opportunities.

METHODS : A systematic literature review following the PRIMSA flow-chart was performed in February 2021 through PubMed and Scopus databases concerning CAR T cell therapy supply chain and logistics. No restrictions in terms of year of publication, language, country and type of document were adopted.

RESULTS : Of the 37 unique documents retrieved and screened, 20 were excluded, while 5 additional articles were included after reference list scan. A total of 22 articles were then included in the narrative synthesis. The articles included in the review report analyses conducted mainly in the United States, United Kingdom and France. The distribution over time of the results starts from 2016 and peaks in 2020. Several issues related with CAR T cell therapy supply chain and logistics were identified, as multiple stakeholder collaboration, centralization/decentralization of the manufacturing site activities (single facility vs. network and impact on turn-around of cells manufacturing), managerial challenges related with personalization, logistics aspects (shipping and storage of living cells, cross-border shipping), implementation of allogeneic models (that could significantly reduce aggregate costs of goods facilitating economies of scale).

CONCLUSIONS : The review revealed that supply chain management challenges are both related to manufacturing process and stakeholders’ interactions. However, process analytical technologies can help the optimization of manufacturing and delivery processes of these therapies.