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Background and Importance Chimeric antigen receptor (CAR) T-cell therapies have transformed the treatment landscape of relapsed/refractory large B-cell lymphoma (r/r LBCL). However, their clinical success poses new challenges in expanding indications, sustainability, and manufacturing optimisation. Evidence suggests that extended vein-to-vein time (V2Vt) may compromise clinical efficacy and economic value.Aim and Objectives The aim of this study is to evaluate the impact of V2Vt on both clinical and economic outcomes in the treatment of r/r LBCL with currently approved CAR T-cell therapies.Material and Methods A literature review was conducted according to PRISMA guidelines using the PubMed, Web of Science, and Scopus databases. Studies published between 2020 and 2025 reporting quantitative data on the association between V2Vt and economic or survival outcomes, such as life years (LYs), quality-adjusted life years (QALYs), and cost-effectiveness analyses, were included. Data were extracted, analysed, and qualitatively synthesized.Results Five studies met the inclusion criteria. In the >3-line setting, reducing V2Vt from 54 to 24 days was associated with a gain of 3.2 LYs and 2.4 QALYs per patient, with an incremental cost of USD 92,587 per QALY gained for axicabtagene ciloleucel compared with tisagenlecleucel. Even smaller reductions in V2Vt, from 37 to 24 days, were clinically relevant, translating into an additional 2.5 LYs and 1.9 QALYs. Similarly, in the second-line setting, axicabtagene ciloleucel, characterised by a higher prevalence of short V2Vt (<36 days), demonstrated an incremental gain of 0.56 QALY compared with lisocabtagene maraleucel, along with a total cost reduction of USD 13,156. Moreover, economic models with a 50-year time horizon identified axicabtagene ciloleucel as a dominant treatment option, with a net monetary benefit of USD 96,407 at a willingness-to-pay threshold of USD 150,000 per QALY.Conclusion and Relevance Available evidence demonstrates that reducing V2Vt not only improves survival and quality of life but also represents a key determinant of the economic sustainability of CAR-T therapies. Therefore, implementing procurement strategies aimed at accelerating manufacturing and logistic processes is essential to secure timely and efficient therapy delivery.References and/or Acknowledgements 1. Locke FL, et al. Impact of Vein-to-vein Time in Patients With R/R LBCL Treated with Axicabtagene Ciloleucel. Blood Adv. 2025 Jun 10;9(11):2663–2676. doi: 10.1182/bloodadvances.2024013656.Conflict of Interest No conflict of interest