Real-World Use, Outpatient Dosing and Transitions of Care in Academic and Community Settings
Panelists discuss how successful outpatient bispecific therapy requires robust infrastructure, including 24-hour monitoring capabilities, emergency department coordination, and liberal use of supportive medications.
EP: 1.Later R/R MM Treatment Landscape and Unmet Needs
EP: 2.ASCO 2025: MonumenTAL-1 Extended Follow-Up for Talquetamab in R/R MM
EP: 3.Insights From MonumenTAL-1: Impressions of Updated Efficacy Outcomes
EP: 4.MonumenTAL-1: Implications of Talquetamab, Prior TCR, and Sequencing for R/R MM
EP: 5.Safety Updates and Concluding Thoughts From Extended Follow-Up of MonumenTAL-1
EP: 6.Talquetamab in R/R MM: Managing GPRC5D-direced AEs, Prophylaxis, and New Safety Signals
EP: 7.A Review of Outpatient Step-Up Dosing for Talquetamab in R/R MM
EP: 8.Real-World Use, Outpatient Dosing and Transitions of Care in Academic and Community Settings
Successful implementation of outpatient talquetamab administration in community settings requires comprehensive infrastructure development and multidisciplinary team coordination. Essential components include establishing protocols for cytokine release syndrome (CRS) management, staff training programs, pharmacy support for medication access, and coordination with local emergency departments for after-hours coverage. The Mayo Clinic experience demonstrates that liberal use of supportive care medications, including early tocilizumab and dexamethasone administration, can successfully prevent high-grade complications in the outpatient setting.
Community practices face unique challenges in obtaining insurance approval for prophylactic medications and establishing the necessary support systems for safe outpatient administration. Key strategies include developing standardized order sets, creating patient education materials, implementing electronic medical record alerts for patients receiving bispecific therapy, and establishing clear communication pathways between oncology teams and emergency departments. The availability of prophylactic tocilizumab, supported by recent NCCN guideline updates, may facilitate broader community adoption of outpatient protocols.
Successful community implementation also requires careful patient selection, considering factors such as caregiver support, proximity to medical facilities, and patient understanding of treatment-related risks. Essential infrastructure elements include 24-hour physician availability, established relationships with local emergency departments, ready access to tocilizumab and corticosteroids, and protocols for patient monitoring and follow-up. The development of standardized approaches to outpatient bispecific administration could significantly expand access to these highly effective therapies while maintaining patient safety standards.
