Immunotherapy Hub

Resources for Bispecific T-Cell Engagers 

Explore the world of bispecific T-cell engagers (BTCE), also known as “bispecifics” or “BiTEs,” with our NCODA resources. Learn how to implement these agents in any clinical setting. Access agent-specific resources for a closer look at individual therapies and access valuable example standard operating procedures (SOPs) from real practices. 

Our resources are divided into 3 main sections:  

1. Overview of BTCEs 
2. Agent-Specific Resources 
3. Example SOPs and Documents 

Example SOPs and Documents  

We’re excited to share sample protocols, procedures, and resources from our members! While these resources are de-identified, we’ve highlighted details about the clinic or hospital size and any unique features about the document to help you find the right fit for your institution. 

There’s no one-size-fits-all approach, so take a closer look and discover what works best for your practice. 

Note: NCODA makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way.  

Education  

• Staff Education for Using Bispecific T-cell Engagers (Mid-sized, Community Cancer Clinic) 

• Patient Education (Mid-sized, Partially integrated, Community Cancer Clinic) coming soon 

Inpatient Use of BTCE 

• Inpatient Use of Bispecific T-cell Engagers (Large Academic Medical Center)  

Management of Adverse Reactions 

• Cytokine Release Syndrome 

• • Bispecific T-Cell Engager Associated Cytokine Release Syndrome (CRS) Management (Mid-sized, Rural Community Cancer Clinic) 

• • Bispecific T-Cell Engager Associated Cytokine Release Syndrome (CRS) Management (Large Community Cancer Clinic) 

• • Bispecific T-Cell Engager Associated Cytokine Release Syndrome (CRS) Management (Large Academic Medical Center) coming soon 

• Neurotoxicity 

• • Bispecific T-Cell Engager Neurotoxicity Management (Mid-sized, Rural Community Cancer Clinic) coming soon 

• • Bispecific T-Cell Engager Neurotoxicity Management (Large Community Cancer Clinic)  

• • Bispecific T-Cell Engager Neurotoxicity Management (Academic Medical Center) 

On-Call and Triaging Practices 

• On-Call Symptom Interventions for Patients Receiving Bispecific T-Cell Engagers (Mid-sized, Community Cancer Clinic) 

• Telephone Triage of Patients Undergoing Bispecific T-Cell Engager Therapy (Mid-sized, Community Cancer Clinic) 

• On-Call Responsibilities for Nurses Managing Bispecific T-Cell Engagers (Mid-sized, Community Cancer Clinic) coming soon 

Ordering and Billing 

• Bispecific T-Cell Engager Ordering and REMS Compliance (Mid-sized, Community-Cancer Clinic with Satellite Clinics)  

• Bispecific T-cell Engager Billing Procedure (Mid-sized, Community Cancer Clinic) coming soon 

Transitioning Patients 

• Transitioning Patients on Bispecific T-Cell Engagers Between Care Settings (Mid-sized, Partially Integrated, Community Cancer Clinic) coming soon 

Recommended Reading 

1. Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus grading for cytokine release syndrome and neurologic toxicity associated with immune effector cells. Biol Blood Marrow Transplant. 2019;25(4):625-638. doi:10.1016/j.bbmt.2018.12.758. 

1. Crombie JL, Graff T, Falchi L, et al. Consensus recommendations on the management of toxicity associated with CD3×CD20 bispecific antibody therapy. Blood. 2024;143(16):1565-1575. doi:10.1182/blood.2023022432. 

1. Mahmoudjafari Z, Ali A, Davis J, Sandahl T, Nachar V, Mancini R. Seamless navigation of bispecific therapies: optimizing management and outpatient access with a focus on coordination. J Adv Pract Oncol. Published online September 11, 2024. doi:10.6004/jadpro.2024.15.8.15. 

1. Atembina L, Boehmer L, Terrell K, et al. Multidisciplinary provider insights to promote adoption of bispecific antibodies to treat cancer in the community. Blood. 2021;138(Supplement 1): 4033. doi:10.1182/blood-2021-153794. 

Acknowledgements 

We extend our heartfelt gratitude to all individuals who contributed to the development of these resources, whether through sharing examples of their practices, participating in meetings to discuss their expertise, or providing invaluable insights; your involvement has been instrumental to our success. 

Key insights that helped in development of these resource were provided by: Allison Mendoza, PharmD; Bob Phelan, RPh; Bradley Yelvington, PharmD, BCOP; Brooke Adams, PharmD, BCOP; Corey Jordan, PharmD; Eden A Biltibo, MD, MSCI; Emilie Aschenbrenner, PharmD, BCOP; Jane Osterson, RN; Justin Konkol, PharmD, BCPS, DPLA; Joyce Wong, MD; Kevin Krueger, PharmD, MBA; Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, FAPO; Maddie Koppin, PharmD; Melinda Rhoades, PharmD, BCOP; Mike Seppelfrick, PharmD; Man-Yee Merl, PharmD, BCOP; Nick Bouchard, PharmD; Sam Abdelghany, PharmD, MHA, BCOP; Stephen Clark, PharmD, BCOP; Zahra Mahmoudjafari, PharmD, MBA, BCOP, FHOPA