COA survey finds broad community adoption of bispecific cancer therapies

A national Community Oncology Alliance survey found most independent community oncology practices already administer bispecific therapies in-office, but many say reimbursement, monitoring support and hospital coordination are holding back growth. COA plans to use the findings to shape advocacy and resources for practices treating cancer patients closer to home.

Why it matters: - Bispecific therapies are moving into routine community oncology care, which could keep more patients close to home instead of traveling to hospitals or academic centers. - The survey also shows the operational load is high, with practices asking for payment, monitoring tools and stronger hospital pathways to make in-office treatment sustainable.

What happened: - The Community Oncology Alliance released results from a national survey on how independent community oncology practices deliver bispecific therapies. - COA fielded the survey to its networks over four weeks in June and July 2026. - The survey received 104 responses, including 97 from respondents who identified as working in independent community oncology practices. - COA said the findings show substantial adoption of bispecific therapies in community oncology, alongside reimbursement gaps, monitoring demands and coordination problems with local hospitals.

The details: - 91.4% of 93 respondents said their practices currently administer bispecific therapy in-office. - 89.6% of 77 respondents said they provide maintenance dosing in-office for all patients. - 51.3% of 78 respondents said difficult or nonexistent hospital coordination for managing cytokine release syndrome, or CRS, and immune effector cell-associated neurotoxicity syndrome, or ICANS, was a barrier. - 75.3% of 77 respondents wanted reimbursement codes covering nursing and pharmacy monitoring time. - 75.3% of 77 respondents wanted clinical monitoring tools that could reduce staff burden. - Respondents said their practices prescribe bispecific therapies across hematologic malignancies and solid tumors. - Respondents also reported participation in clinical trials involving investigational bispecific products. - Among 76 respondents, 32.9% said the nearest hospital or academic medical center able to administer bispecific therapies was more than 25 miles from their office. - Other barriers included a lack of reimbursement for staff monitoring time, cited by 35.9% of respondents, and monitoring requirements that were too time-intensive for staff, cited by 28.2%. - Respondents also prioritized fair product coverage and reimbursement, operational guidance and shared standard operating procedures, patient and caregiver resources, and stronger collaboration with hospitals. - COA said the number of respondents varied by question.

Between the lines: - The survey suggests the clinical model is already in place in many community practices, but the supporting infrastructure has not caught up. - Hospital coordination appears to be the biggest friction point because bispecific therapy can require urgent evaluation or admission for CRS and ICANS. - The travel data points to a practical access issue: some patients may need to go far farther for hospital-based treatment than for care delivered in their local oncology office. - Christine Pfaff, COA’s director of clinical initiatives, said community practices are already delivering bispecific therapies and taking responsibility for ongoing treatment, but payment and hospital pathways have not kept pace. - COA said the findings will help guide advocacy, education and resources for practices building or sustaining bispecific-therapy programs.

What’s next: - COA will use the survey results to support advocacy and education aimed at helping community oncology practices expand bispecific-therapy programs. - Practices are likely to keep asking for reimbursement mechanisms, monitoring tools and clearer hospital relationships as bispecific use expands. - The full survey results are available here.

The bottom line: - Community oncology practices are already delivering bispecific therapies at scale, but reimbursement, monitoring and hospital coordination remain the main barriers to wider adoption.