Cellular therapy processing laboratory: a workforce hiring nightmare

Navigating workforce needs in the field of cell and gene therapy: results of workforce survey performed by the ISCT early-stage professionals committee

BACKGROUND AND AIM

The workforce landscape in the field of cell and gene therapy (CGT) continues to evolve. As new therapies receive approval and numerous clinical trials are underway, there is an increasing demand to understand training and career development within the CGT sector. The International Society of CGT (ISCT) early-stage professionals (ESP) committee has been conducting workforce surveys to understand the existing skillset of CGT professionals, including ESP, and to highlight critical areas where training programs may be required. Here, we report the findings of these muti-year workforce surveys.

METHODS

The survey was designed by ESP committee members and distributed primarily to ISCT members and the Canadian CellCAN network, mainly targeting ESPs (those within 10 years of their final degree or entry into the CGT field). The 2020 and 2021 surveys consisted of 19 questions covering respondents' educational background, demographics, employment status, employment sector and participation in continuing education. In 2023, the survey was expanded to include an additional 8 qualitative questions focusing on career development opinions and opportunities. The number of respondents was 58 in 2020, 61 in 2021 and 109 in 2023. Trends and summaries of the results over the 3 years are reported here.

RESULTS

Manufacturing and process development were the most common job roles, as well as the most desired skills and the biggest workforce gap in the CGT sector. Over the 3 years, the percentage of respondents in managerial roles increased while those working in a Good Manufacturing Practice environment decreased. On the other hand, the percentage of respondents with an MS degree decreased, while those with a PhD degree showed an overall increase from 2020 to 2021 with a slight decrease in 2023. Finally, participants concluded that the lack of available positions as well as the lack of opportunities or support are the key hindrances in their career development.

CONCLUSIONS

Collecting data to evaluate the workforce and training remains an important venture in the CGT field. Our survey showed that manufacturing and process development roles are in great demand, suggesting the need for continued workforce training of this critical need. The trends observed through the survey years also suggest a possible effect of the COVID-19 pandemic on the CGT workforce, which may have stabilized since 2023. Overall, our survey shows that there is a need to address the workforce gap while also paying attention to the career development of those aspiring to join the CGT workforce.

Perspectives on the use and availability of chimeric antigen receptor T cells (CAR-T) and cell therapies: A worldwide cross-sectional survey by the worldwide network for blood and marrow transplantation (WBMT)

Chimeric antigen receptor T cell therapy (CAR-T) cells represent a new generation of autologous, allogeneic and personalised cell-based therapies that have revolutionised the treatment of B cell haematological malignancies. Despite their significant effectiveness in treating challenging relapsed and refractory diseases, access to this cutting-edge treatment remains a critical issue globally, even in high income countries. To gain insights into these challenges, the Worldwide Network for Blood & Marrow Transplantation (WBMT) initiated a survey focused on the state of CAR-T and cellular therapy availability worldwide. The survey aimed to identify the accessibility, manufacturing capabilities, apheresis, accreditation, reimbursement, presence of regulatory frameworks and legal oversight of these cell-based therapies. The survey included questions on demographics, the respondent's centre, CAR-T availability, details about haematopoietic stem cell transplant programs, supply and indications for CAR-T, quality assurance, and information about other cell and gene therapy products beside CAR-T. Conducted online over three months in 2023, the survey garnered 181 complete responses from various geographical regions, from North America, Asia, Europe, South and Central America, Australia and New Zealand, and Africa. Our findings suggested a promising level of awareness and interest in CAR-T therapy globally, even in lower-income regions. However, survey respondents cited cost as the primary barrier to access, alongside infrastructure and governmental support issues. The survey also highlighted the varying reimbursement strategies across regions, with costs in Europe and North America being relatively similar while Asia showed more variability. There was also variability in the regulatory and accreditation frameworks associated with delivery of these novel therapies As CAR-T therapy continues to grow, innovative solutions such as global partnerships, in-house production, and the establishment of cellular therapy centres in developing countries are essential. Addressing the challenges of access requires a comprehensive approach that combines efforts to lower costs, enhance healthcare infrastructure, and foster international collaborations, ensuring that CAR-T therapy becomes available to all who need it.

A multi-institutional survey of apheresis services among institutions in the United States

INTRODUCTION

Apheresis practices in the United States (US) have not been comprehensively characterized to date. This study aimed to address this gap by evaluating apheresis therapy through a national survey.

METHODS

A multi-institutional survey was conducted between April and July 2023. The survey, comprising 54 questions, focused on institutional demographics, procedures, equipment, staffing, training, and impacts of the Coronavirus Disease 2019 (COVID-19) pandemic. Responses from 22 institutions, primarily academic medical centers, were analyzed.

RESULTS

Therapeutic plasma exchange (TPE) was the most common procedure, followed by hematopoietic progenitor cell collection (HPC-A) and red blood cell exchange (RCE). CAR-T cell collections were widespread, with some institutions supporting over 30 protocols concurrently. Most sites used the Spectra Optia Apheresis System, were managed by a transfusion medicine service, and employed internal apheresis providers. Insufficient staffing levels, exacerbated by the COVID-19 pandemic, were common and most often addressed using overtime.

DISCUSSION

The survey highlighted the ubiquity of TPE, expanding cellular collections and staffing challenges. The role of apheresis in supporting cellular therapy, particularly in newly developing cell and gene therapies and clinical trials, was evident. Staffing issues during the pandemic emphasized the need for innovative recruitment strategies.

CONCLUSION

This nationwide survey provides the most comprehensive analysis to date of apheresis practices in large US academic centers.

National Survey of FACT-Accredited Cell Processing Facilities: Assessing Preparedness for Local Manufacturing of Immune Effector Cells

The utilization of the human immune system as a therapeutic modality has materialized in the form of novel biologics known as immune effector cells (IECs). However, currently approved IECs rely on autologous cells for manufacturing that are funneled through costly centralized supply chains leading to long wait times and potentially increased mortality. Alternative models for manufacturing at or near the point-of-care in a distributed and local approach are being proposed to overcome such a bottleneck. Cell processing facilities for minimally manipulated products, as well as academic good manufacturing practice facilities, are being considered for such manufacturing tasks. However, the infrastructure and the practices of these facilities remains unstudied. Here, we surveyed the cell processing facilities accredited by the Foundation for Accreditation of Cellular Therapy (FACT) in the United States to better understand their preparedness for local manufacturing of IECs. A structured survey consisting of 40 items was distributed to the directors of 157 facilities. The survey evaluated 6 domains, including facility characteristics, quality practices, personnel, use of automation, experience with IECs, and the perception of the point-of-care model. Thirty-eight facilities completed the survey (24.2%). Most facilities were involved in handling IEC products (35/38, 92.1%), and the majority had infrastructure to support basic operations and quality control such as viability (36/36, 100%), identity (33/36, 91.7%), and sterility (33/36, 91.7%). The quality practices varied among the facilities depending on the types of products processed. A slight majority implemented automation in their workflows (22/38, 57.9%). Facilities expressed a general interest in adopting point-of-care models (23/38, 61%), with financial and human resources identified as the most significant constraints. In conclusion, FACT-accredited cell processing facilities may provide the infrastructure required for local manufacturing. However, there is a need for standardization and minimum quality requirements to effectively implement such models.