Multidisciplinary Provider Insights to Promote Adoption of Bispecific Antibodies to Treat Cancer in the Community

Bispecific antibodies (BsAbs) are an emerging class of novel immunotherapy agents that have led to major breakthroughs in the treatment of hematologic malignancies. By targeting two separate antigens at the same time, BsAbs can bridge tumor cells to cytotoxic immune cells and bypass several limitations of conventional monoclonal antibody treatment (Wang et al., 2019). In 2020, the Association of Community Cancer Centers (ACCC) launched an ongoing education program to identify and address barriers to awareness, preparedness, adoption, and use of BsAbs to treat cancer. As part of this program, ACCC developed a survey with an expert Advisory Committee to gain an understanding of multidisciplinary cancer providers' experiences with BsAbs. The survey primarily assessed experiences with blinatumomab, the first FDA-approved bispecific antibody for the treatment of malignancy (Newman & Benani, 2016). One hundred and twenty-nine individuals responded to the survey. Sixty percent of these respondents reported prescribing, dispensing, and administering blinatumomab and/or caring for patients being treated with blinatumomab. Of those respondents, 44% were medical oncologists/hematologists, 8% were advanced practice providers (APPs), 17% were nurses, 23% were pharmacists, and 9% fell into an ‘Other’ category of various other disciplines. Interestingly, the provider experience with blinatumomab varied greatly. Ninety-two percent of oncologists indicated having experience with blinatumomab while only 35% of nurses reported so. Regarding how blinatumomab is used in the community, respondents indicated that 59% of their institutions use it to treat relapsed or refractory acute lymphoblastic leukemia (ALL) while 41% use it to treat ALL with MRD positivity. Additionally, 74% of oncologists use blinatumomab before CAR-T therapy when considering both therapies for patients with ALL. Survey results also showed that although 79% of providers felt comfortable caring for patients being treated with blinatumomab, 59% identified barriers when caring for these patients. Some of the common challenges include transitioning patients from the inpatient to outpatient setting (41%), managing patients in remote areas (33%), securing insurance coverage (28%), managing side effects (27%), assisting patients with costs (24%), and lacking in-house expertise with the drug (22%). Another reported obstacle was the management neurotoxicity and cytokine release syndrome (CRS). In the survey, less th