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Introduction
Cell and gene therapies (CGT) have redefined what is possible in medicine, and, in doing so, it has challenged what is required to deliver medicine safely and effectively. The treatments entail extraordinary scientific complexity: intricate manufacturing processes, strict logistics, narrow administration windows, and clinical workflows spanning entire institutions. The physician who ultimately prescribes a CGT is, in many respects, just one node in a highly coordinated network of specialists who must understand, prepare for, and execute their role meticulously.
This reality positions Medical Science Liaisons (MSLs) in a uniquely consequential role. In the CGT space, scientific education is not only informative; it is operationally essential. When members of the care team lack the knowledge needed to support complex therapies, the consequences can echo outward, affecting the adoption and use of a product. These may include delayed authorizations, product handling errors, missed monitoring windows, or patients who ultimately never receive treatment. MSLs who understand this dynamic situation and engage the full breadth of the treatment team with the same rigor they apply to physician engagement become something more than scientific resources. They become enablers of therapy delivery itself.
This article discusses how MSLs can most effectively engage the diverse stakeholders involved in CGT programs, including transplant coordinators and nursing teams, pharmacists, cell therapy laboratories, financial teams, and hospital administrators. It also examines why this engagement is critical not just for scientific literacy, but also for successful real-world patient access.
Expanding the Definition of Key Stakeholders
One of the most important shifts an MSL can make when entering the CGT space is to expand their definition of a “key stakeholder”. In traditional pharmaceutical settings, MSL engagement frequently focuses on a relatively defined set of thought leaders, investigators, and specialist physicians. In cellular therapy programs, the treatment pathway itself requires a broader reach.
Transplant coordinators sit at the operational heart of many cellular therapy programs. They are often the individuals managing the day-to-day logistics of patient eligibility assessments, donor searches, procedure scheduling, and cross-departmental communication. Their effectiveness depends not just on administrative competence, but on a genuine understanding of the therapy itself, how it is manufactured, the timeline of apheresis to infusion, and how clinical variables can affect that timeline. When MSLs engage coordinators with this level of scientific depth, they are not simply sharing information; they are helping coordinators anticipate problems prior to their occurrence and make decisions with the full picture in view.
A similar logic applies to nursing teams. Nurses often have the most direct, sustained contact with patients during therapy administration and the critical post-infusion period. Sometimes, an in-service education session by MSLs is warranted for the infusion nurses to ensure the determination of proper logistics of transfer of the product from the cell lab to the clinic. Recognizing early signs of toxicities such as cytokine release syndrome and neurotoxicity, comprehending the nuances of product-specific monitoring requirements, and knowing when escalation is necessary are all essential to patient safety. MSL engagement with frontline nursing staff, customized to the realities of their clinical environment, builds the kind of practical scientific fluency that directly protects patients.
Clinical Pharmacists and Cell Therapy Laboratories: Safeguarding Product Integrity, Preparation, and Administration
Clinical pharmacy and cell therapy laboratory teams operate at a critical juncture in the therapy delivery chain, between the manufacturing facility and the patient. Their decisions during product receipt, verification, storage, preparation and handling chain of custody carry direct implications for product integrity and patient safety. The handling requirements may be highly specific, the storage conditions tightly controlled, and the consequences of protocol deviations could be severe. MSLs who engage pharmacy and cell lab teams with a clear articulation of the product’s biological characteristics, handling requirements, and the scientific rationale behind the institutional protocols they are being asked to follow will find that pharmacists are deeply motivated partners. These are professionals trained to think rigorously about drug safety and what they need is the scientific foundation to apply that rigor to a new class of therapies where MSLs play a critical role in education.
Access, Infrastructure, and the Broader Institutional Network
Even when clinical teams are fully prepared, patients may still face barriers to treatment if the institutional infrastructure around them is not properly aligned. The financial and administrative architecture of a cellular therapy program is, in many ways, as complex as the science itself. Prior authorization processes, reimbursement pathways, and payer negotiations require specialized expertise. Delays in any one of these areas may have a serious impact on patients who may not have the luxury of time.
Although MSLs do not typically lead access conversations, they are particularly suited to support them. Financial coordinators and access teams benefit from having a clear scientific understanding of the therapy they are advocating for, including what it is, how it works, and why it represents a meaningful clinical advance. By liaising with their internal market access colleagues to ensure that scientific resources and talking points are appropriately adapted for payer audiences, MSLs can meaningfully reduce the friction that stands between a clinical recommendation and an approved treatment.
At the leadership level, hospital administrators and program directors shape the conditions under which all of this work takes place. Decisions about staffing, facility investment, training infrastructure, and program expansion are ultimately made at the administrative level, and they are made more effectively when administrators have a clear picture of what a cellular therapy program actually requires. MSL engagement with institutional leadership is not about marketing a product; it is about ensuring that the people making structural decisions have the scientific context to make them well. Centers that clearly understand the resource intensity of a cell therapy program before it is adopted are far better positioned to build sustainable programs capable of delivering consistently excellent care.
Conclusion
The delivery of cell and gene therapies is fundamentally a team effort. No single clinician or department carries this work alone, and no single point of failure is trivial when the tolerance for error is this narrow. What ultimately allows such complex therapies to move from clinical evidence to patients who receive them is a shared foundation of scientific understanding across the entire care team. MSLs are uniquely positioned to build that foundation. Not because they are the only source of scientific expertise, but because they can move fluidly across the key players with a consistent scientific narrative designed for the precise needs of each audience.
As the CGT landscape continues to mature and expand with more products, more treatment centers, and more patients who might benefit, this connective role will only grow in importance. The MSLs who recognize, embrace, and execute this responsibility with rigor will not simply be supporting therapy delivery; they will be making it possible.
About the author:
Sanil Sansar, PhD
Sanil Sansar is a seasoned Senior Medical Science Liaison in hematology and cell therapy. He currently serves as a Senior MSL at Gamida Cell, where he supports innovative therapies in the stem cell transplant field. He has over 5 years of experience in medical affairs, including prior roles at Sanofi and Kadmon Pharmaceuticals, where he supported launch and post-approval education and research efforts in chronic graft-versus-host disease (cGVHD) and rare diseases.
Sanil brings deep expertise in engaging transplant centers, interpreting complex data, and identifying unmet needs in stem cell transplantation and multiple myeloma areas. He has played a key role in onboarding major academic institutions, developing tailored engagement plans to drive awareness and optimize clinical integration of novel therapies. Sanil is passionate about improving patient access to transformative therapies and continues to advocate for innovation in hematologic malignancies and cellular medicine.
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