For referring clinicians

CAR-T referral pathway.

A structured route for treating clinicians to share a case for CAR-T cell therapy assessment. Referral is a request for review — it is not an indication that a patient is eligible.

Helpful to share

What the assessment usually needs.

Confirmed diagnosis, histology and immunophenotype
Current disease status — relapsed, refractory or in remission
Number and type of previous treatment lines
Previous transplant or cellular therapy, if any
Recent imaging and disease-burden assessment
Organ function — cardiac, renal, hepatic, pulmonary
Infection screening status
Performance status and caregiver support

Records and documents

Please do not attach patient records to this form. Summarise the case here; the team will share a secure channel for reports, pathology and imaging after first contact, so that patient information is never uploaded to public storage. For urgent clinical discussion, call +91 93104 05193.

Background on the pathway, risks and eligibility: CAR-T cell therapy.

Request a CAR-T assessment for a patient

This is a referral request. It does not confirm acceptance, eligibility or availability of cellular therapy.

Reason for request

Full name

Phone

Include the country code if you are outside India.

Preferred consultation mode

Cancer type

New or existing patient

Preferred date

Today or later, Institute time (India).

Preferred time

A preferred time only — the team will confirm a suitable slot.

Suitability for cellular therapy is decided only after specialist assessment. Please do not enter diagnosis, treatment history, medication or report findings on this form — the team will collect the clinical information it needs through an appropriate channel.

Who is making this request?

Referring clinician and centre (if applicable)

Anything else the team should know (optional, non-sensitive)

Please do not include detailed medical information, reports, scan findings or genomic results here. A short note about what you would like to discuss, or your preferred times, is enough.

I agree that the Institute may use the details above to contact me about this request.

I am the treating or referring clinician for this patient and I am permitted to discuss their case with the Institute.

Your details are used only to respond to this request. This form is not a medical consultation. For urgent or emergency medical concerns, contact your local emergency service or attend the nearest appropriate emergency department.

Prefer to discuss the case first?

A clinician-to-clinician conversation is often the quickest way to establish whether assessment is worthwhile.

Contact the institute About CAR-T therapy