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Bispecific antibodies are moving into earlier lines of treatment for relapsed/refractory multiple myeloma — and community practices are figuring out how to deliver them safely outside the hospital. Experts say outpatient eligibility depends less on comorbidities and more on having a reliable caregiver and nearby access to care. Prophylactic tocilizumab and routine IVIG are emerging as non-negotiable pillars of safe community-based delivery.
Bispecific antibodies are no longer just a last resort for multiple myeloma — they're moving into earlier lines of therapy, and community oncology practices are working to keep pace. At a recent OncLive Scientific Interchange and Workshop, experts tackled the practical question of how to safely administer these agents outside academic medical centers.
The FDA's March 2026 approval of teclistamab plus subcutaneous daratumumab (based on MajesTEC-3 data) introduced a powerful new earlier-line option, with a 36-month PFS rate of 83.4% vs. 29.7% for standard of care. Phase 3 MajesTEC-9 data, presented at ASCO 2026, further showed teclistamab monotherapy outperforming investigator's choice in patients with 1–3 prior lines of therapy.
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Why it matters: As bispecifics shift from academic centers to community clinics, building the right infrastructure — caregiver support, ER education, infection prevention protocols, and prophylactic tocilizumab — is critical to ensuring patients everywhere can safely access these highly effective therapies.
