EHA 2026 | Implementing bispecific antibodies into community practice: overcoming misconceptions & fears

Well, you know, I wouldn’t say pitfalls, and it’s kind of funny because everybody thinks that the big fear of uptake of bispecifics in the community is just the CRS or neurotoxicity management. And while that is very much true, there are a lot of other barriers that exist, you know, in terms of monitoring. Can the patients be safely monitored? Is there a program? Is there a team, you know, nurses, nurse practitioners, physician assistants that can, that can help in the monitoring. So I think the hard part is one, it’s the lack of awareness, right? Something, when something is new, it’s scary, right? Side effects that are not, have not been dealt with before are scary. And so I think, you know, just realizing that and relying on the tools that are out there now for CRS management in terms of escalation pathways of what to do if a patient has a fever, what’s the first intervention, really relying on those tools. And I think just, you know, just getting used to doing it, right? Starting your first patient. So I wouldn’t really say they’re pitfalls. I think they’re more just misconceptions that, well, no, I can’t do this because a patient may have CRS. But the whole point of step-up dosing is to mitigate that risk and lower as much as possible. And what we’re seeing with some of the bispecific combinations, like I mentioned, epcoritamab-R-squared, is by having those other agents on board, you’re actually lowering the risk of CRS that was reported in the studies that looked at monotherapy bispecific. So you’re taking these percentages down by, you know, over 20%, and most of those events are low-grade. So I think it’s just, it’s almost taking it stepwise to do step-up dosing and to understand, you know, you’re introducing the drug into the immune system. And as long as you have a good, you know, escalation protocol in place, I think this can be done. And, you know, always asking for help. There’s always physicians around who have done this. You know, I always say community sites should rely on other community sites. Ask those sites, how did you do it? What did you do? What did your monitoring program look like? I think it’s really important.

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