OBJECTIVES: Hospitalization at home (HAH) is a French specific organization delivering hospital care at home. As part of a national ambulatory care policy, HAH for cancer intravenous treatments is becoming a priority. This work aims to describe the specificities of ICI infusion at home.

METHODS: Through national hospital database (PMSI), all patients with at least one ICI infusion in 2019 were identified. Patients’ characteristics and ICI infusion specificities in hospitals and in HAH were described. Patients’ journeys (time to infusion in HAH, time spent in HAH protocols, alternation of infusion in HAH and in hospitals after HAH infusion initiation) were retrospectively analyzed (maximum of 5-year prior period) using swimmer plots and clustering algorithms.

RESULTS: In 2019, 36,526 patients received ICI at least once in hospitals including 60 who had infusions at home. Patients treated at home were 62.2 years old (65.5 yo in hospitals) and 61.7% male (67.4% in hospitals). HAH’s patients suffered from lung cancer (77%; 61% in hospitals) and melanoma (23%; 14% in hospitals). HAH patients were mainly treated with nivolumab (58%, 54% in hospitals). Seven out of 22 French regions experienced home ICI infusion (min:1; max:21 patients). Average time from first infusion in hospitals to HAH initiation was close to one year (341 days, [95%CI 268-413]) and average time spent between first and last infusion in HAH was 115 days [95%CI 80-150]). Two types of HAH management protocol were observed: ‘All infusions in HAH’ and 'Alternation of infusions in HAH and hospitals.

CONCLUSIONS: This first study on ICI infusion at home through HAH highlights its limited use in France and the heterogeneity of the patients’ journey. In the context of the COVID-19 epidemic, a greater number of patients infused with ICI at home is expected. An update of this study in 2020 would be of interest.