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Outpatient Administration of BiTEs in Community Oncology Clinics

Published Date: October 14, 2025

Outpatient Administration of BiTEs in Community Oncology Clinics

Written by: Bradley Winegar, PharmD, Cassandra Perkey, PharmD, BCOP, Cherise Steib, PharmD, Darell Connor, PharmD, MHA, David Gajewski, PharmD, MBA, Jennifer Lilly, RPh, Manale Maksour, PharmD, BCPS, Melody Chang, RPh, MBA, BCOP, Nick Grove, PharmD, MBA, Nicole McMullen, PharmD, BCOP, & Robert Carr, PharmD, BCOP, BCPS

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BiTE therapy is opening doors for patients with relapsed or refractory disease, but bringing it into community oncology is not as simple as adding a new drug to the infusion schedule. The biggest challenge is safety in the outpatient setting, especially around cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS), and how those risks show up during early dosing and monitoring.

This article focuses on what it actually takes to make outpatient BiTE administration workable in community practice. It outlines the operational lift behind step-up dosing, the need for standardized protocols and clear escalation pathways, and the infrastructure required to support patients during the highest-risk window after dosing. It also shares a real outpatient approach that includes structured education, home self-monitoring supplies, and coordination with local emergency departments so patients can receive timely care if symptoms emerge.

Key highlights

  • Why CRS and ICANS drive the outpatient conversation for BiTEs
  • The step-up dosing reality that makes scheduling and monitoring complex
  • What “hospital-at-home” safety looks like for community oncology programs
  • The AON outpatient model, including education and home self-monitoring kits
  • Why practices are planning ahead with on-hand tocilizumab and clear escalation routes

Read the full article in Oncolytics Today for a closer look at outpatient BiTE administration in community oncology, including step-up dosing logistics, monitoring expectations, and safety planning for CRS and ICANS.

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