Opinion
Video
Matthew Pianko, MD, outlines the logistical considerations involved when implementing bispecific antibodies for the treatment of multiple myeloma, including the roles of the project champion and other stakeholders as part of a multidisciplinary team.
This is a video synopsis/summary of a Practice Pearls involving Ryan Haumschild, PharmD, MS, MBA; Matthew Pianko, MD; and Anthony Perissinotti, PharmD, BCOP.
Pianko discusses leading the implementation of bispecific antibodies at his academic medical center, University of Michigan Health, which had existing infrastructure from staff trained to identify and manage cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. When commercial bispecifics became available, Pianko organized a working group involving key stakeholders like hematologist/oncologists, inpatient/outpatient pharmacy specialists, nursing staff, the admitting service, and finance teams. They optimized patient flow between outpatient and inpatient, aligning on processes for admission logistics, step-up dosing, dose delays, adverseeffect management protocols, and discharge planning.
Pianko emphasizes the need for ensuring that experienced staff members recognize adverseeffects, having consistent protocols to manage them, streamlining patient transitions, and identifying all outpatient/inpatient providers that will interact with patients across settings. Given high inpatient capacity, there is interest in transitioning care outpatient, when possible, through their “outmigration project.”
Haumschild agrees on the value of a multidisciplinary group determining processes. Althoughstep-up dosing was initially inpatient, training staff enabled outpatient administration. He highlights the need for after-hours supportive care access because adverse effects often occur at night and on weekends. Developing local infrastructure and pathways for community providers unfamiliar with managing bispecific-related adverseeffects is critical.
Video synopsis is AI-generated and reviewed by Pharmacy Times® editorial staff.