ACCC created a survey to better understand the experiences of multidisciplinary cancer providers with bispecific antibodies, with an emphasis on the experience with blinatumomab. The results of the survey were presented in a summary during the American Society of Hematology’s annual meeting and exhibition in 2021.
Bispecific antibodies have been big news in the world of hematology for some time, with the first such therapy, blinatumomab, approved since 2014, which targets both CD19 on the surface of B-cell lymphoblasts and CD3 on the surface of T-cells aims.1 The 2-for-1 punch of these novel immunotherapies can overcome the limitations of traditional monoclonal antibodies.
In 2020, the Association of Community Cancer Centers (ACCC) launched an ongoing education program to identify and address barriers to the adoption of bispecific antibodies for the treatment of hematologic malignancies. For this program, ACCC created a survey to better understand the experience of multidisciplinary cancer providers with these therapies, with an emphasis on the experience with blinatumomab. The results of the survey were presented in a summary during the American Society of Hematology’s annual meeting and exhibition in 2021.2
According to the abstract, 129 individual responses were received, with 66% of those surveyed indicating that they prescribed, dispensed, administered and / or cared for patients treated with blinatumomab. Of these, 44% were medical oncologists / hematologists, 8% advanced practice providers (APPs), 17% nurses, 23% pharmacists and 9% fell into a “different” category in various other disciplines.
The providers’ experiences with blinatumomab vary; 92% of oncologists had experience with blinatumomab, while only 35% of nurses reported it. In terms of community use, respondents said 59% of their facilities use it to treat relapsed or refractory acute lymphoblastic leukemia (ALL), and 41% use it to treat ALL with minimal residual disease positivity. Notably, 74% of oncologists reported using blinatumomab prior to T-cell therapy with chimeric antigen receptors when choosing between the two options for patients with ALL.
The survey also found:
- 79% of providers feel comfortable caring for patients treated with blinatumomab, but 59% identified barriers in caring for these patients.
- Challenges include moving patients from inpatient to outpatient (41%), managing patients who live in remote areas (33%), securing insurance coverage (28%), managing adverse events (27%) ), the support of the patient in coping with the financial costs, (24%) and a lack of in-house know-how with the drug (22%).
- The management of neurotoxicity and cytokine release syndrome has also been described as a challenge. Less than half of oncologists said they had experience in this area, and only 6 to 9% of APPs said they had experience. Notably, 23% of nurses felt they did not have all of the information needed to administer blinatumomab safely.
- 86% of respondents said that written guidelines, best practices, and care recommendations would be helpful. Resources requested included a list of blinatumomab pharmacies and home care agencies, care coordinators or navigators, care transitions best practices, and outpatient management information.
- The drug manufacturer’s expertise and direct patient education were seen as beneficial, and 70% believed that peer support services for patients would also be helpful.
- Mullard A. FDA approves first bispecific. Nat Rev Drug Discovery. 2015; 14 (7). doi: 10.1038 / nrd4531
- Atembina L, Böhmer L, Terrell K, et al. Multidisciplinary insights from providers to promote the adoption of bispecific antibodies for the treatment of cancer in the community. Presented at: 63rd American Society of Hematology Annual Meeting & Exposition; 11-14 December 2021; Atlanta, GA. Summary 4033. https://ash.confex.com/ash/2021/webprogram/Paper153794.html