On-Body Injectors Point to At-Home Care, but Hurdles Remain in US

Joseph Mikhael, MD, MEd, professor in the Clinical Genomics and Therapeutics Division at the Translational Genomics Research Institute, an affiliate of City of Hope Cancer Center, discusses the future potential of home administration for subcutaneous isatuximab (Sarclisa Escena) utilizing an automated on-body injector following its FDA approval. He emphasizes how the technology could redefine care delivery in multiple myeloma. Although self-administered and home-based oncologic therapies remain relatively rare due to complex health care systems and administrative challenges, particularly within the United States, the mechanical simplicity of the on-body injector makes at-home administration a realistic future objective. In health care jurisdictions that already support home delivery for subcutaneous medications, this device offers an ideal platform to accelerate that transition.

The fundamental design of the on-body injector distinguishes it from traditional manual subcutaneous pushes, which inherently require trained clinical personnel to administer. Because the device simply adheres to the skin, automatically infuses the medication, and is easily removed, the procedure is straightforward enough for patient self-administration. Although Mikhael stresses that clinicians value regular in-person interactions to monitor disease progression, he acknowledges that many patients would strongly prefer the independence, comfort, and convenience of receiving effective therapies in their own homes. Transitioning routine administrations out of the clinic aligns with broader, modern efforts to make cancer care more patient-centered.

However, Mikhael notes that establishing widespread home administration will take time, requiring health care systems to navigate regulatory, logistical, and reimbursement hurdles. In the interim, the on-body injector delivers immediate, substantial benefits within traditional practice environments. The device provides unprecedented operational flexibility across both academic medical centers and community oncology clinics. By removing the strict requirement for dedicated infusion suites, treatments can be safely administered in general patient exam rooms or secondary clinical areas. He says that the adaptability simplifies clinic scheduling, reduces spatial bottlenecks, and offers an efficient alternative to standard intravenous infusions.