Clinical Implications of Real-World Outpatient/Hybrid Patient Management

These data present a significant advancement in the administration of bispecific antibodies for multiple myeloma, particularly highlighting the shift toward outpatient and hybrid dosing strategies. Traditionally, patients receiving teclistamab were admitted for monitoring during the initial doses due to the risk of cytokine release syndrome (CRS). However, these study findings demonstrate that outpatient or hybrid dosing—where patients may receive part of their treatment in a hospital and partly as outpatients—is both feasible and safe. The results show comparable efficacy and safety outcomes between inpatient and outpatient settings, suggesting that with proper patient selection and monitoring, many patients can be managed outside the hospital without compromising treatment effectiveness.

The efficacy data remain consistent with those from previous registration studies, with overall response rates near 70% and durable responses observed in both cohorts. This underscores that outpatient step-up dosing does not negatively affect treatment outcomes. Patient selection is crucial, with those having higher disease burden or lacking adequate caregiver support being better suited for inpatient care. For the majority, however, outpatient management is appropriate and beneficial, offering convenience without sacrificing safety. The incidence and severity of CRS and immune-related toxicities remain low and manageable in both settings, further supporting this shift in clinical practice.

Implementing outpatient dosing requires a multidisciplinary approach involving physicians, advanced practice providers, nurses, pharmacists, social workers, and thorough patient education. Patients must be reliable in recognizing symptoms and have clear communication pathways for urgent concerns. Practical measures such as home thermometers and well-defined action plans are essential. Emerging data, including prophylactic strategies, continue to enhance safety and reduce adverse events, making outpatient administration increasingly viable. Overall, this evolution in care delivery not only maintains clinical outcomes but also expands access and convenience for patients receiving bispecific antibodies in multiple myeloma.