Bispecific Therapies Expand Outpatient Treatment Options for Lymphoma and Leukemia

In an interview with Pharmacy Times, Cherise Steib, PharmD, HDDP, discussed how bispecific therapies are expanding treatment options for patients with lymphoma and leukemia, particularly those with relapsed or refractory disease. Steib explained that these agents offer highly targeted immunotherapy for patients who may previously have had limited options.

Bispecific therapy may also serve as an alternative for individuals who are not eligible for chimeric antigen receptor T-cell therapy because of overall health, access barriers, or other practical considerations. It may be especially valuable when disease is progressing rapidly and treatment must begin without the prolonged preparation associated with some cellular therapies.

However, determining whether treatment can be delivered safely in the outpatient setting requires careful evaluation. According to Steib, one of the most important considerations is whether the patient has a reliable caregiver who can remain available around the clock, particularly during the step-up dosing period, when the risk of cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome is greatest.

Patients should also live within approximately 1 hour of a hospital so they can receive urgent care if complications develop. In addition, both patients and caregivers must understand the potential adverse effects of therapy, know when to seek medical attention, and have access to required supportive care medications.

When these safeguards are in place, outpatient treatment can offer meaningful benefits. Patients may receive therapy in the clinic and return home for monitoring rather than remain hospitalized overnight, improving convenience and comfort.

Outpatient administration may also reduce pressure on hospital resources by preserving inpatient beds for individuals with urgent or emergent needs. Steib emphasized that successful outpatient bispecific therapy depends on selecting appropriate patients, establishing clear safety requirements, and ensuring that patients and caregivers are fully prepared to participate in monitoring throughout treatment.