Dr Beck on the Practical Realities of Subcutaneous Oncology Drug Delivery

In an interview with Targeted Oncology^TM, J. Thaddeus Beck, MD, discusses how the transition from intravenous (IV) to subcutaneous drug formulations is shaping oncology practice. Beck notes that subcutaneous injections and wearable delivery devices have existed for at least a decade. The shift from IV to subcutaneous versions of oncology drugs has taken place over a similar period.

Beck says the main challenges are logistical. Patients may need to unbutton their shirt for an injection into the abdominal wall, so subcutaneous delivery requires more privacy and space than an IV placed in the arm, and clinics must design areas accordingly. Some formulations are refrigerated and must be warmed before use, so teams need to time drug availability and mixing solutions to the patient’s arrival.

On patient preferences, Beck emphasizes that every patient is different. Some may dislike exposing their abdomen in public, and patients have varying demands on their time. However, he says the time savings often outweigh these barriers. Some of the first drugs to receive subcutaneous formulations saved 8 hours of infusion time and a full day in the office, which made patients and clinicians eager to adopt them.

Looking ahead, Beck expects subcutaneous delivery to keep expanding, in line with current trends. His practice has not used on-body applicators extensively, as they carry a greater risk of unexpected failure than direct injection in the office. He notes, however, that newer and more convenient technologies are emerging. On-body systems may become more feasible for medications given subcutaneously over longer periods.