Establishing Best-Practice Workflows for Managing CRS With Bispecific Antibody Therapy in a Community Oncology Setting

Multidisciplinary teams developed a real-world, best-practice framework to support safe and coordinated bispecific T-cell–engaging antibodies (BsAbs) delivery in community settings to better manage cytokine release syndrome (CRS) events in community oncology practices, according to results from a study published in Journal of the Advanced Practitioner in Oncology. 

Community oncology practices continue to face operational challenges in managing cytokine release syndrome (CRS), a common treatment-related complication as BsAbs become more widely used in the treatment of hematologic malignancies.

Researchers conducted a qualitative analysis through focus groups which included 13 hematology-oncology professionals, MDs, PharmDs, and nurse providers. 

Using theme matrix analysis, researchers identified 3 key areas of focus: 

1.    Developing coordinated workflows

2.    Strengthening partnerships between community practices and hospital systems

3.    Supporting patient and caregiver education.

Implementation of workflow for the management of CRS among patients treated at community practices were often driven by real-world triggers including FDA approval of BsAbs, clinical trial participation, addition of BsAbs to practice formularies, and protocol development via practice champions. Key operational steps included establishing improved communication protocols during and after hours, assigning training leads for BsAb and CRS education, and formalizing multidisciplinary coordination plans between oncology providers, pharmacy staff and affiliated hospitals.

Hospital training and inpatient admission planning were noted as essential to facilitate safe BsAb initiation and rapid CRS management. Additionally, communication pathways between outpatient and inpatient teams were tailored to always ensure CRS treatment availability.

Importantly, continuous patient and caregiver education was emphasized, particularly on the risks, symptoms, and escalation protocols related to CRS, as well as how to access urgent care when needed.

The researchers concluded, “BsAb use in community settings requires multidisciplinary coordination between practices and hospitals. Actions included identifying practice champions, establishing clear workflows for transitioning patients between inpatient and outpatient settings, and ensuring continuous training of staff, patients, and caregivers.”

Source:

Donnellan W, Lin SW, Abbas J, et al. Operationalization and Use of Bispecific T-Cell–Engaging Antibodies in Community Practices: Multidisciplinary Perspectives on Developing Logistics and Workflow for Cytokine Release Syndrome Management. jadpro. Published June 25, 2025. doi:10.6004/jadpro.2025.16.7.19