In the wake of Kymriah's approval, the ability to ensure a sustainable manufacturing and supply chain emerged as a major differentiator among CAR T contenders. With deep pockets, Novartis AG leveraged its global R&D and manufacturing expertise "to take a cutting-edge, complicated individualized process from the first three patients treated at Penn and expand it to a clinical trial program across 25 centers and four continents, forming the basis for the regulatory filing in the U.S. and, soon, Europe," explained Bill Hinshaw, general manager of U.S. Oncology for the Basel, Switzerland-based company.