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PERSPECTIVE article

Front. Oncol.

Sec. Hematologic Malignancies

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1630146

A Roadmap to Implementing Outpatient Administration of Bispecific Antibodies in Multiple Myeloma

Provisionally accepted
Alfred  L. GarfallAlfred L. Garfall1Rahul  BanerjeeRahul Banerjee2Laurent  FrenzelLaurent Frenzel3Cyrus  KhandanpourCyrus Khandanpour4Yi  LinYi Lin5Erica  OttoniErica Ottoni6Robert  RifkinRobert Rifkin7Sarah  RockwellSarah Rockwell8Cesar  RodriguezCesar Rodriguez9Humberto  VillefortHumberto Villefort10Elena  ZamagniElena Zamagni11,12*
  • 1University of Pennsylvania, Philadelphia, PA, United States
  • 2Fred Hutchinson Cancer Center, Seattle, WA, United States
  • 3Department of Hematology, Hospital Necker, Paris, France
  • 4Universitätsklinikum Münster, Münster, Germany, and University Hospital Schleswig-Holstein Campus Lübeck, University Cancer Center Schleswig-Holstein and University of Lübeck, Lübeck, Germany
  • 5Mayo Clinic, Rochester, MN, United States
  • 6Hospital Moinhos de Vento, Porto Alegre, Brazil
  • 7Rocky Mountain Cancer Centers/US Oncology Research, Denver, CO, United States
  • 8Florida Cancer Specialists & Research Institute, Tampa, FL, United States
  • 9Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • 10A.C.Camargo Cancer Center, São Paulo, Brazil
  • 11IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy
  • 12Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy

The final, formatted version of the article will be published soon.

INTRODUCTION: Bispecific antibodies (BsAbs) are novel immunotherapy agents for the treatment of relapsed/refractory multiple myeloma (RRMM). Currently, 3 BsAbs (teclistamab, talquetamab, and elranatamab) are approved for the treatment of RRMM. Administering BsAbs in different practice settings is crucial to improving treatment access and patient outcomes. This report provides actionable guidance to implement safe and effective administration of BsAbs for patients with RRMM in outpatient and community settings. METHODS: Three clinician advisory workshops were held in the United States, Europe, and Latin America to discuss key factors to operationalize BsAb use in outpatient and community settings, focusing on the critical phases of practice setup, treatment initiation, and ongoing management. RESULTS: BsAb administration in outpatient and community settings requires careful planning, a well-prepared multidisciplinary team (MDT) of healthcare professionals, and clear protocols, including MDT composition, roles/responsibilities, capacity planning, patient selection criteria, step-up dosing procedure, admission processes, patient/caregiver education requirements, and adverse event (AE) monitoring/management. Comprehensive MDT training on protocols and preparedness to manage AEs is essential. Patients initiating outpatient BsAb therapy should have a reliable caregiver, access to a hospital, controlled comorbidities, and no active infections. Ensuring patients and caregivers understand the benefits, risks, and expectations of BsAb therapy is vital for successful treatment and a positive patient experience. CONCLUSION: Administering BsAbs in outpatient and community settings can be done safely and effectively with appropriate planning and protocols. Enabling safe and effective BsAb administration in these settings is essential to ensure more patients with RRMM have access to treatment and improved outcomes.

Keywords: Multiple Myeloma, bispecific antibodies, bispecifics, outpatient, Teclistamab, talquetamab

Received: 16 May 2025; Accepted: 30 Jun 2025.

Copyright: © 2025 Garfall, Banerjee, Frenzel, Khandanpour, Lin, Ottoni, Rifkin, Rockwell, Rodriguez, Villefort and Zamagni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Elena Zamagni, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.