Q&A: Implementing BiTE Therapies in Community Oncology Settings

By Melody Chang, RPh, MBA, BCOP

AON Vice President of Pharmacy Operations

August 27, 2026 in Education, Patient-centric Care

Bispecific T-cell engager (BiTE) therapies have moved beyond research settings into both academic and community oncology practices. Yet some practices hesitate to offer the therapies due to concerns about complexity, cost and potential side effects.

Melody Chang, RPh, MBA, BCOP

American Oncology Network (AON) has created the Bispecific T-Cell Therapy Educational Series, a four-part virtual program that runs through December to provide practical guidance on administering and managing BiTE therapies in the community setting.

This free program is designed for physicians, advanced practice providers, nurses, pharmacists, and pharmacy technicians. Successful participants will earn four continuing education credits. The curriculum covers clinical indications, mechanisms of actions and key safety considerations, including cytokine release syndrome (CRS) and neurologic toxicities.

The four modules address:

Multiple myeloma
Lymphoma and solid tumors
Operationalizing BiTE therapies in the community setting
Toxicity recognition and management

AON Vice President of Pharmacy Operations, Melody Chang, RPh, MBA, BCOP, runs the program. Below, she discusses BiTE therapies, emerging treatments and how BiTE can be implemented cost-effectively in community oncology settings.

Q: Briefly explain BiTE therapies and their implications for patients.

A: Bispecific antibody therapies represent a significant advancement in cancer treatment, offering new options for patients when traditional therapies may not be enough. These innovative treatments offer new hope, particularly for patients with cancers that may be resistant to traditional treatments. Bispecific therapies work by harnessing the body’s immune system to identify, target and eliminate cancer cells. They have shown great promise in blood cancers, while newer designs are beginning to address certain solid tumors.

Q: What are bispecific antibodies?

A: Unlike conventional treatments, bispecific antibodies used in cancer therapy are specially engineered proteins that can simultaneously bind to cancer cells and T-cells, a type of immune cell responsible for attacking harmful invaders. Think of them as a bridge linking two distant islands. By forming this connection, bispecific antibodies help the immune system recognize and destroy cancer cells more effectively.

Q: Are BiTE therapies too difficult or too new to offer in community settings?

A: Absolutely not. BiTE therapies are an established class of immunotherapy with multiple recent approvals and an expanding clinical pipeline. The field is rapidly evolving, but administering BiTE therapies in a community setting is well-established. Researchers are developing more specific and multispecific engagers while working to address challenges such as cytokine release syndrome, off-tumor toxicity and T-cell exhaustion.

Q: How are bispecific antibody therapies being used in cancer care at AON?

A: Bispecific antibody therapy connects immune cells to cancer cells, allowing AON oncologists to provide treatment that is specifically tailored to a patient’s needs.

AON also actively participates in clinical trials and collaborates with leading researchers to advance the use of bispecific antibodies in cancer treatment. Our goal is to continue exploring the potential of these therapies to improve quality of life and treatment effectiveness for our patients.

Q: How many AON practices offer BiTE therapies, and what types of cancers are being treated?

A: Nearly 80% of AON practices offer BiTE therapies for patients with the following cancers:

Acute lymphoblastic leukemia
Uveal melanoma
Diffuse large B-cell lymphoma
Follicular lymphoma
Multiple myeloma
Extensive-stage small cell lung cancer

Therapies are customized for each patient. Some patients begin treatment with an inpatient hospital admission for initial step-up dosing and observation before transitioning to outpatient maintenance therapy, while others are treated entirely on an outpatient basis within a community oncology practice.

Q: What patient safety considerations should practitioners keep in mind?

A: Bispecific antibody therapies can cause potentially serious or life-threatening side effects, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). These side effects typically occur during initial treatment and require immediate medical attention. Patients receiving bispecific antibody therapy must be closely monitored, particularly during step-up dosing, and specific protocols must be in place to manage these complications.

Q: What are the other treatment considerations?

A: Regular monitoring is essential during bispecific antibody treatment. To ensure patient safety, initial doses are typically given in a hospital setting, where patients are closely observed for signs of adverse reactions, particularly during the initial treatment phases. However, some patients may be eligible to receive initial doses in an outpatient setting with close monitoring by their medical team.

Q: How can I learn more about implementing BiTE therapy in a community oncology setting?

A: Physicians, advanced practice providers, nurses, pharmacists and pharmacy technicians can register to attend AON’s four-part Bispecific T-Cell Therapy Educational Series. The series, offering 4.0 CE credits, covers clinical indications, mechanisms of actions, and key safety considerations such as cytokine release syndrome (CRS) and neurologic toxicities. Participants will gain practical insights into administering and managing BiTE therapies in the community setting, guided by AON’s clinical framework and educational tools. Register here.