| Sumario: | Significance & Background: At a Comprehensive Cancer Center (CCC) serving 64,000 patients annually Bispecifics Immunotherapies have played a major role in treatment a variety of diagnoses. This innovative modality evaluation revealed critical gaps in administration, monitoring, and toxicity management. These gaps potentially posed risk to achieving optimal patient outcomes and improved quality of life for cancer patients. Purpose: To outline systemic and procedural strategies for evaluating, developing, implementing, and administering bispecific immunotherapies across both approved and research protocols. Interventions: A multidisciplinary committee--comprising executive leadership, nursing, pharmacy, physicians, research, advanced practice providers (APPs), and patient care coordinators (PCCs)--conducted a comprehensive evaluation of current practices and data to inform strategic recommendations. Key initiatives included transitioning the site of treatment from in-patient to outpatient settings to mitigate the financial toxicity associated with bispecific antibody administration. Integration of EPIC tolls (flowsheets, dot phrases, flags) into workflows for optimal documentation and affirmation of processes for comprehensive risk identification and management post initiation of therapy. The committee worked to enhance and further develop targeted curriculum and educational tools focused on cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Triage pathways were established to support the assessment and intervention of bispecific-related toxicities, particularly for high-risk cases. To operationalize these initiatives, the Comprehensive Cancer Center (CCC) implemented defined workflows for standard-of-care (SOC) therapies and investigational products (IP) while launching a dedicated clinic for IP patient care and infusion. Results: Evaluation across programs demonstrated improved consistency in language and procedures from study initiation to drug administration. Ongoing education was essential to build staff competency and confidence, requiring iterative updates based on emerging knowledge. Consistency and alignment in treatment and toxicity management were optimized in research and SOC bispecific administration. Collaboration across interdisciplinary teams helped to address the gaps identified for successful mitigation and administration of patient care needs. A permanent Bispecific Joint Committee was formed to sustain and evolve processes, ensuring continued optimization of care delivery. Discussion: The Bispecific Joint Committee will monitor and make changes as indicated with ongoing analysis. With the ongoing emergence and utilization of High-Risk Bispecifics requires ongoing collaboration between clinical trials and SOC to address evolving toxicities as they are revealed in oncology innovation.
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