Presentation (CTI)

OBJECTIVES: Atezolizumab subcutaneous (SC) is licensed for the same indications as the intravenous (IV) formulation with comparable pharmacokinetics, efficacy and safety. Cancer patients have reported a preference for SC atezolizumab versus IV with clinicians hypothesising that SC allows patients to spend less time in care settings. However, the real-world quantification of perceived time savings of SC versus IV, has not been evidenced in the UK. The aim of this study was to assess the impact of SC versus IV administration time of atezolizumab monotherapy within chemotherapy-treatment units (CTUs).
METHODS: This retrospective study analysed patients (n=257) with Non -Small Cell Lung Cancer or Urothelial Carcinoma who were treated with atezolizumab monotherapy (Dec 2022-Dec 2024), in a UK NHS Cancer Centre. A time-to-event analysis investigated the CTU length of stay (LoS) between IV and SC visits. Log-rank testing assessed statistical significance.
RESULTS: Kaplan-Meier analysis revealed significant differences in CTU LoS between treatment modalities. Median CTU LoS was 97 minutes for IV visits (IQR: 77-127 minutes) compared to 43 minutes (IQR: 32-63 minutes) for SC visits, representing a 54-minute difference (55.7% reduction; Cohen’s d = 1.25). Log rank testing confirmed significantly different duration of stay on CTUs (x² = 261.26, p<.001), indicating patients receiving SC atezolizumab were discharged substantially faster than IV patients. In 96 (n=/976; 9.7%) visits where CTU LoS was 30 minutes or less, SC atezolizumab was administered in 99% of visits (n=95/96; x² =118.84, p<.0001), with an average duration of 25 minutes.
CONCLUSIONS: This study demonstrates that SC atezolizumab compared to IV delivery significantly reduces CTU chair time. Further research is warranted into the potential clinical implications for increased service capacity and more efficient use of service resources.