How AON Supports Safe Outpatient Bispecific Therapy in Community Oncology

In an interview with Pharmacy Times, Cherise Steib, PharmD, HDDP, discussed how the American Oncology Network (AON) developed a structured program to support the safe administration of bispecific therapies in the outpatient community oncology setting. The program brings together pharmacists, nurses, providers, and other clinical staff members who have direct contact with patients throughout treatment.

Steib explained that AON’s outpatient bispecific therapy policy provides a framework for closely monitoring patients, particularly during the step-up dosing period, when the risk of cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS) is greatest. The program also establishes appropriate follow-up procedures and ensures that patients understand the potential risks associated with treatment.

Patient and caregiver education are central components of the program. Before beginning therapy, patients and caregivers participate in training led by nurses or other clinical staff members. During these sessions, they learn how to measure important vital signs and recognize symptoms that could indicate CRS or ICANS. Educational guides and tutorials are also provided to reinforce the information and help patients respond appropriately if complications arise at home.

The program allows selected patients to self-monitor outside the clinic while maintaining access to on-call providers who can assist if an urgent concern develops. AON has also created guidance for outside hospitals and emergency departments to support the recognition and management of CRS or ICANS if a patient seeks emergency care.

Steib emphasized that pharmacists play a critical role in operationalizing outpatient bispecific therapy. Pharmacists educate clinical staff, assist with building treatment regimens, develop patient education materials, and answer clinical questions from providers. They also offer guidance on dosage adjustments and toxicity management when needed.

By working closely with nurses, providers, patients, and caregivers, pharmacists help ensure that outpatient bispecific therapy is delivered safely and consistently. Steib noted that this multidisciplinary coordination is essential for preparing clinics, managing treatment-related risks, and supporting patients throughout their care.