SOHO 2026 | Improving access to T-cell redirecting therapies for multiple myeloma: outpatient care models

Yeah, so there’s been tremendous progress in myeloma over the last five years with T-cell redirecting therapies, both bispecific T-cell antibodies and CAR-T therapies, and really showing unprecedented efficacy, not only in terms of overall response rates, but durable response. But the reality is, is that despite how transformative these agents have been, the majority of patients who are eligible to receive these agents still don’t have access to these agents in a local oncology setting. So this is really an unmet need of how do we improve access to these drugs for patients in their local treatment setting. And so there are many barriers to access to these drugs, but one barrier to access is care models that require mandatory hospitalization for the delivery of these agents, either CAR-T therapies or bispecific antibodies. So there’s really been a huge push over the last three to five years of how can we actually develop care models that then incorporate outpatient delivery of these agents for better access to patients. And I think in the community oncology setting, this is incredibly important because this is sort of a non-negotiable, non-starter for many practices. Many practices are not sort of under the same institutional umbrella as your local hospital. Many of them don’t have an established partnership with the local hospital to deliver these agents. And so I think definitely it’s something that can be done, particularly bispecific antibodies in an outpatient setting, in the local community oncology practice, and certainly also with CAR-T as well. It is important, though, to plan ahead. And so really thinking about the operational considerations of delivering these drugs in the outpatient setting, thinking sort of about laying the groundwork, establishing who are the key stakeholders in this process, mapping the care model, and really, again, bringing all the stakeholders together, mapping the patient journey step by step from start to finish. And once that’s done, then bringing the standard operating procedures, the protocols in place to really standardize the process, educating everyone that may be involved, both internally and externally. So thinking about the clinic staff, external partners, such as local emergency rooms, hospitals, as well as caregivers and patients. And then constantly then reevaluating, looking at metrics of quality and saying, how can we further refine this process? So, you know, it is really important to plan ahead, but at the same time, particularly with outpatient step-up dosing of bispecific antibodies, which I think is probably the lowest hanging fruit and definitely doable and scalable in a community oncology practice. It’s something, again, that’s doable, important to plan ahead, but at the same time, important not to overcomplicate it as well. And I think it’s also important to keep in mind that one size doesn’t fit all. So what works well for one practice may work differently for another practice. And so, again, look at how things might work internally for one’s own practice setting to actually implement these agents.

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