Opinion
Video
A panel of medical experts discuss obstacles hindering the full potential of bispecifics.
The following is a video synopsis/summary of a Peer Exchange involving Ryan Haumschild, PharmD, MS, MBA, CPEL; Kirollos Hanna, PharmD, BCPS, BCOP, FACCC; Sarah Rockwell, PharmD, BCOP; Melody Chang, RPh, MBA, BCOP; and Ryan Cain, PA-C.
The video discusses potential issues and opportunities with utilizing bispecific monoclonal antibodies in cancer care. Barriers exist in patient access and treatment center experience with these novel therapies. Patients in rural or suburban areas may lack proximity to academic or community centers familiar with bispecific administration protocols. The frequent dosing schedule also poses transportation challenges.
During treatment, infections requiring therapy holds or dose modifications add complexity. Restarting after holds requires decisions on re-initiation dosing and potential referral to academic centers. Grade 3 or 4 infections and hematologic adverse events are common during maintenance therapy. Sequencing bispecifics with other therapies like chimeric antigen receptor T-cell therapy also lacks clarity.
However, opportunities exist to overcome these barriers through clinical trials and coordination between academic and community providers to ensure appropriate outpatient delivery. Well-defined protocols can facilitate identification of hospitalization needs, preemptive medication dosing, patient monitoring, and triage lines. Designating organizational champions to oversee bispecific implementation across disease states can also streamline the process.
Video synopsis is AI-generated and reviewed by AJMC editorial staff.
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