Best Practices in Expanding Access to Bispecific Antibodies and Adverse Event Management

Bispecific antibodies are an emerging class of novel immunotherapy agents with tremendous treatment potential. With more than 50 bispecific antibodies currently in clinical trials, their use in community cancer care is expected to increase as their indications expand to include more diseases that are routinely treated in outpatient settings, such as myeloma and solid tumors. However, barriers, such as serious treatment-related toxicities and other practical considerations, have limited its widespread use, particularly in the community-based setting.

To optimize care for patients being treated with bispecific antibodies and to explore early identification and management of adverse events common in patients on bispecific antibodies, the Association of Cancer Care Centers (ACCC) has developed an educational initiative—“Best Practices in Expanding Access to Bispecific Antibodies and Adverse Event Management”—in partnership with the Society for Immunotherapy of Cancer (SITC). This program was made possible by support from Johnson & Johnson Healthcare Systems, Inc.

The aims of this educational program include:

• Exploring practical solutions and best practices in transitioning patients to/from community and academic oncology practice settings, with an emphasis on monitoring for cytokine release syndrome
• Highlighting the importance of creating institutional protocols, which draw upon the strengths of a multidisciplinary team, to guide the management of adverse events more common with bispecific antibodies
• Discussing what ideal care coordination looks like, inclusive of pathways and standard workflows to minimize cytokine release syndrome

This initiative extrapolates from ACCC’s 2020 bispecific antibodies education project that sought to prepare community oncology providers for use of bispecific antibodies by identifying barriers to awareness, preparedness, and implementation. Preliminary research and findings from ACCC’s 2020 survey on bispecific antibodies revealed common challenges community-based providers experienced. Of the 129 total survey respondents, identified challenges included transitioning patients from the inpatient to outpatient setting (41%), managing patients in remote areas (33%), securing insurance coverage (28%), managing side effects (27%), assisting patients with treatment-related costs (24%), and lacking in-house expertise with the drug class (22%).

As Srinivas Devarakonda, MD, associate professor in the Division of Hematology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University and Advisory Committee member of ACCC’s 2020 bispecific antibodies project explains, “There is an inpatient to outpatient transition that must be very meticulous, so as not to miss any days of treatment. And in that, it takes a village…because you need insurance approvals and coordination with the infusion agency, nurses, local pharmacy, and local facility that would be comfortable managing the patient’s side effects if something were to happen.”

Thus, improvements in communication and coordination across the continuum of care of is essential to lay the groundwork for implementation of these complex treatments into the community care setting.

Issues Brief: Best Practices in Expanding Access to Antibodies and Adverse Event Management

Building upon the previous work of "Best Practices in Expanding Access to Bispecific Antibodies and Adverse Event Management," this resource explores ways to expand patient access to BsAbs and identify methods to optimize the early identification and management of treatment-related adverse events (TRAE) with a focus on cytokine release syndrome (CRS).
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