An APP-Led Outpatient Bispecific Antibody Clinic

This is the fifth blog post in a 6-part series recognizing the achievements of the 2026 ACCC Innovator Award winners before their in-depth sessions at the ACCC 43rd National Oncology Conference. Learn more about the innovations being recognized this year and those who pioneered them by joining ACCC in Boston, Massachusetts, from October 21-23, 2026.

In the rapidly advancing field of immuno-oncology, bispecific antibodies (BsAbs) continue to garner the interest of both academic and community cancer centers due to their rapid growth in FDA approvals and increasing use in hematologic malignancies and solid tumors. However, practical considerations such as treatment-related toxicities, choosing the right delivery model, and staffing constraints deter many programs from BsAb implementation.

Understanding both the benefits to be had from offering BsAb therapy to its community and the scope of this undertaking, Vanderbilt-Ingram Cancer Center took a novel approach with its advanced practice provider (APP)-led BsAb step-up dosing clinic. With APPs at the helm, this model enables efficient and specialty-expert management of therapies while optimizing physician resources. In addition, its adherence to step-up dosing protocols prioritizes patient safety and convenience while reducing inpatient resource utilization.

This model has reaped numerous institutional benefits, such as saving 137 of the 192 recommended inpatient days for monitoring, increasing outpatient billing revenue for clinic visits and drug costs, and strengthening community partnerships, in addition to winning the cancer center a 2026 ACCC Innovator Award. In anticipation of the ACCC 43rd National Oncology Conference this fall, ACCCBuzz spoke with Kathryn Kennedy, MSN, APRN, ACNP-BC, AOCNP, Outpatient Hematology APP Team Lead at Vanderbilt-Ingram Cancer Center, to learn more about the program.

ACCCBuzz: How long has Vanderbilt-Ingram Cancer Center been an ACCC member? 

Kennedy: We’ve been a member for 10 years.

ACCCBuzz: What do you enjoy most about being an ACCC member? Are there specific programs, resources, or tools that you use at your cancer program?

Kennedy: We’ve been involved with several programs related to the delivery of bispecific antibodies, and we’ve gotten a lot out of those resources. Having access to the Oncology Issues journal, the ACCCBuzz blog, and the CANCER BUZZ podcast has been invaluable as well. The breadth and specificity of ACCC’s content are also impressive. Recently, I found resources on improving the care of patients with myeloproliferative neoplasms, and I appreciate the wide array of topics ACCC covers.

ACCCBuzz: What makes your cancer center unique?

Kennedy: We’re both big and small at the same time. We’re National Cancer Institute–designated, a member of the National Comprehensive Cancer Network, and we have a robust clinical trial program. We’re a large academic medical center with our main downtown campus, but we also have many satellite locations throughout the community. In that way, there’s a community feel while still having access to the resources Vanderbilt has to offer—such as clinical trials, providers who specialize in myeloma or lymphoma, and our strong partnerships with community practices in Alabama, Virginia, and Kentucky.

ACCCBuzz: It can be challenging for administrators and C-suite members to share a common language with clinicians and others who provide direct patient care. Can you share any tips you used to obtain buy-in and support for your innovation?

Kennedy: My role is 90% clinical, so when it came to getting buy-in from the clinical side, it was relatively easy because I knew what kind of evidence and argument was needed. As for the administrative and C-suite side, they already knew our center was frequently pressed for beds. Having to admit patients for 9 to 11 days to ramp up bispecifics really limited our ability to offer this therapy. Taking up beds for that long was an issue everybody recognized, so to that end, the C-suite, clinical, and administrative leaders were ready to come together to solve it. Some innovations experience that push-and-pull about whether the idea is worth pursuing, so we were lucky that everybody was on board and knew we needed change.

We were conscious of the need to involve all relevant parties early: the APPs who would serve as clinicians and the physicians who would create the protocol. As we were developing the protocol, we made it a living document that we could change as needed. It’s important to continually assess what’s working and what could be done differently, and to maintain flexibility, because a new protocol will never be perfect in its first iteration. 

ACCCBuzz: ACCC President Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC, centered her theme on Designing Oncology Care to Meet the Needs of a Growing Patient Population. A key component of that theme is Workforce Empowerment and Enablement, which was key to your innovation. Can you share any insights you have learned in this area?

Kennedy: Our decision to staff the clinic with APPs rather than physicians was grounded in several reasons; namely, the availability, flexibility, and speed with which the clinic could get up and running. Through this initiative, we demonstrated that by investing time and education, APPs can become subject matter experts and effective leaders in delivering BsAb therapy—especially if they have a well-designed protocol to fall back on when they have questions and concerns. Of course, the physician is always there if a major issue arises, but overall, the program has run very smoothly so far. 

Shifting BsAb administration to the outpatient setting is still relatively novel. To do that safely, we had to make sure that we had many different areas of our hospital on the same page—the outpatient team, the inpatient team, the staff who are taking phone calls in the middle of the night, the emergency department—so that if a patient happens to show up to the emergency department, staff would know what to do. To reach that state, there was a lot of education, training, and protocol development to account for a patient with cytokine release syndrome whose care needs to be escalated, for instance.

To learn more about Vanderbilt Ingram Cancer Center’s APP-led outpatient bispecific antibody clinic, join Kathryn Kennedy and her fellow 2026 ACCC Innovator Award winners in Boston this October for the 43rd National Oncology Conference.