Expert Perspectives on Operationalizing Outpatient/Hybrid Step-Up Dosing in Relapsed/Refractory Multiple Myeloma
Experts discuss the feasibility and safety of outpatient bispecific antibody treatment for multiple myeloma, emphasizing the importance of careful patient selection, robust support systems, and multidisciplinary collaboration to manage potential complications such as cytokine release syndrome (CRS) and ensure timely care, highlighting that with these measures, outpatient administration can safely expand access while maintaining efficacy and patient convenience.
EP: 1.Introductions and an Overview of Multiple Myeloma Treatments
EP: 2.Discussing Current Gaps in Multiple Myeloma Care
EP: 3.Real-World Data From IMS: Promising Results in Relapsed/Refractory Multiple Myeloma
EP: 4.Expert Perspectives on Bispecific Monoclonal Antibody Administration in the Community Oncology Setting
EP: 5.Real-World Data From IMS: Outpatient/Hybrid Step-Up Dosing in Relapsed/Refractory Multiple Myeloma
EP: 6.Clinical Implications of Real-World Outpatient/Hybrid Patient Management
EP: 7.Expert Perspectives on Operationalizing Outpatient/Hybrid Step-Up Dosing in Relapsed/Refractory Multiple Myeloma
EP: 8.Key Takeaways From IMS Real-World Data on Managing Step-Up Dosing in Relapsed/Refractory Multiple Myeloma
Findings from this study strongly support the feasibility and safety of administering bispecific antibody treatment for myeloma in an outpatient setting. However, patient selection remains critical. Although most patients can be safely managed with outpatient step-up dosing, approximately a quarter of patients may require inpatient care. Those with high disease burden, low blood counts at baseline (cytopenias), or poor performance status might face higher risk of complications such as CRS and are better suited for closer inpatient monitoring. Additionally, patients must be reliable and capable of recognizing early symptoms of adverse events, with access to a caregiver who can assist in urgent situations.
Managing patients in the outpatient setting also presents challenges, particularly when adverse events such as CRS occur after hours. Having well-established resources and clear protocols is essential to ensure patients can promptly access care. This includes having staff available to field after-hours calls and guide patients on when and where to seek emergency evaluation. Educating emergency department personnel about the specifics of managing these patients is also a key part of ensuring safe transitions of care. Without these supports, outpatient management could become risky or inconsistent.
For centers not yet ready to implement outpatient dosing programs, integrating this emerging knowledge can help facilitate safer and more efficient adoption. A dedicated, multidisciplinary team with appropriate resources is vital to operationalize such a program. Many practices have already begun this transition, recognizing that with careful planning and patient education, outpatient administration of bispecific antibodies is both practical and effective. This shift not only maintains treatment safety and efficacy but also offers patients greater convenience without compromising their care.
