The Pharmacist's Role in CAR-T Cell Therapy: From Protocol Development to Toxicity Reduction

Background: CAR-T cell therapy is cutting-edge immunotherapy for hematologic malignancies, and the pharmacist has a crucial role to play in its safe delivery. Aim: Through this review, the pharmacist's role in CAR-T therapy, ranging from protocol development to toxicity management, is evaluated with consideration of real-world evidence and the future direction. Methods: A Systematic literature review was conducted on PubMed, Embase, and Web of Science using searches for studies between 2017–2025. Relevance to pharmacist roles in CAR-T therapy informed study selection, synthesizing data on protocol management, product handling, and toxicity mitigation. Results: Pharmacists enable regulatory compliance, manage product logistics, and guide toxicity interventions, reducing adverse events by up to 40% in some settings. Case studies illustrate outpatient care (85% ambulatory care) and tocilizumab early start (90% severe CRS prevention). Complications are supply chain interruption and limited specialist roles (20% of centers). Conclusion: Pharmacists are the key to the success of CAR-T therapy, improving safety and outcomes. Dedicated positions and standardized training would be necessary to cope with emerging challenges, especially in outpatient and solid tumor settings.