Use of bispecific antibodies (BsAbs) in community practices: Key attributes to develop logistics and workflow for management of cytokine release syndrome (CRS).

Abstract

e13575 Background: Establishing workflows to monitor and manage CRS in community practice settings presents unique challenges that may not be encountered in more specialized centers. Real world experience was gathered from OneOncology specialists to understand key steps, common challenges, and best practices to establish CRS workflows in community practices. Methods: Qualitative data were gathered via a 90-minute focus group and follow-up interviews. Participants were MD or PharmD community heme-oncology providers in physician-owned practices with 10-20 physicians. As of January 2024, participants had treated over 30 patients with commercially available BsAbs. Theme matrix techniques facilitated data analysis and presentation. Results: Catalysts for developing CRS workflows were the addition of BsAbs to the practice formulary, identification of practice leaders willing to drive protocol development, and education of clinic and hospital staff who would manage patients treated with BsAbs. Key steps in the workflow included defining lines of communication within the practice during and after office hours, designating leads to oversee staff training, and creating practice-specific management plans. A process for potential inpatient admission for moderate/severe CRS was developed in collaboration with hospital administrators and nursing leaders. Lines of communication between the treating practice, pharmacy, and hospital care staff before, during, and after treatment were established, and methods to ensure availability of necessary medications were identified. Finally, patient support and the logistics of patient/caregiver education on BsAb therapy, symptoms of CRS, and how and when to access care was highlighted. Conclusions: Use of BsAbs in the community requires thoughtful coordination between oncology practices and hospitals. Keys to success include defining flexible, practice-specific workflows for managing CRS, transitioning patients efficiently from clinic to inpatient setting, and careful training of staff, patients, and caregivers. [Table: see text]