Outpatient Bispecific Therapy May Be Feasible and Safe in Cancer


Collaboration among nurses, social workers, and others may help in safely administering outpatient bispecific T-cell engager therapy to patients.

It may be feasible and safe to administer bispecific T-cell engager (BiTE) therapy to patients with cancer in an outpatient setting if the right infrastructure is put into place, according to Kathy Mooney, MSN, RN, ACNS-BC, BMTCN®, OCN®.

In a conversation with CancerNetwork® at the 2024 Oncology Nursing Society (ONS) Congress, Mooney, clinical program director at Johns Hopkins Hospital and Johns Hopkins Health System, spoke about the rationale for researching the use of BiTE therapy in an outpatient setting to ensure patient safety. Additionally, she highlighted the importance of collaboration among nurses, pharmacy providers, and social workers to monitor patients during the treatment process.

According to findings that Mooney presented at the meeting, of 19 patients who received teclistamab-cqyv (Tecvayli) in an outpatient setting since January 2023, 15 underwent admission within 30 days after beginning therapy. Additionally, 13 of these patients had cytokine release syndrome and/or immune effector cell-associated neurotoxicity syndrome requiring management, although there were no grade 3/4 toxicities.


We were looking to adopt an outpatient model for our patients [receiving] BiTE therapy. We have experience using outpatient therapy options for bone marrow transplant and CAR T cells, so we felt confident that we could treat our patients [receiving] BiTE in that same space using our same guiding principles. We wanted to make sure that it was safe for the patients, it was feasible, and that we could treat as many patients as possible in that space.

We started the process with a BiTE workgroup. We invited members in different areas of the team, including nursing and pharmacy providers. We had our social work colleagues come and join us. We tried to identify all areas where these patients would be interacting with our team members and make sure that they were included in the workgroup so that they could provide their insights to the process.

What I’d like people to know is that [BiTE therapy] is feasible in an outpatient setting if you have the right infrastructure in place. Thinking through the possibilities of the patients needing admission in a timely fashion and making sure that you have that setup within your program, you can definitely do this in the outpatient setting, and it can be safe for patients.


Mooney K, Allen N, Anderson K, Zukas A. Taking a BiTE out of hospital admission days using a team approach to managing patients at risk for treatment related toxicities. Presented at: 2024 Oncology Nursing Society Congress; April 24-28, 2024; Washington DC.

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