Outpatient Management of Bispecific Antibodies: Safety, Monitoring, and Infrastructure

This segment expands on the logistical framework needed to safely deliver bispecific antibodies in the outpatient setting. Dr. Mehta and NP Bailey outline how toxicity profiles, particularly CRS and ICANS, shape monitoring protocols and determine whether a community practice can administer bispecific therapy independently. Dr. Mehta emphasizes the advantage of having a 24/7 extended care clinic capable of managing grade 1–2 CRS with tocilizumab or corticosteroids, thereby preventing unnecessary emergency department visits or hospital admissions. He describes how proximity to such resources enables more widespread outpatient implementation of bispecific therapies. Bailey adds that patient education serves as the first line of safety, ensuring patients can recognize early symptoms, follow escalation instructions, and maintain adherence to therapy. She describes strategies for empowering patients, particularly older adults, to understand severe but rare risks while reducing unnecessary anxiety. The discussion underscores the strain on inpatient services nationwide and the growing push toward outpatient administration of bispecific therapies. As community practices build capacity and academic partnerships deepen, the segment predicts broader adoption of bispecifics outside major cancer centers. Clinicians gain insight into the infrastructure, communication pathways, and patient management strategies needed to deliver these therapies safely and efficiently.