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Safety, Feasibility, and Patient Experience of Ten-Minute Pembrolizumab Infusions: A Prospective Cohort Study
Elianne C S de Boer1, Helle-Brit Fiebrich-Westra1, Gijs M M Lenis1,2
1Isala Oncology Center, Isala Hospital, Zwolle, the Netherlands.
Purpose:
Rising cancer incidence and staff shortages demand more efficient outpatient oncology workflows. Pembrolizumab is conventionally administered over 30 minutes. This prospective study assessed the safety and patient experience of reducing pembrolizumab infusion duration to 10 minutes to enhance outpatient oncology workflow efficiency.
Methods:
In this prospective single-center study at a large Dutch teaching hospital, adults receiving pembrolizumab for any approved indication were eligible if they had no history of grade ≥2 infusion-related reactions (IRRs). After two standard 30-minute infusions without IRRs, durations were reduced to 15 and subsequently 10 minutes. Vital signs were monitored pre- and post-infusion. Adverse events were graded per Common Terminology Criteria for Adverse Events v5.0. Pembrolizumab trough levels and patient-reported experience measures were collected. The primary end point was the incidence of grade ≥2 IRRs during shortened infusions, with safety predefined as <10%.
Results:
Of 97 enrolled patients, 78 completed the protocol; discontinuation mainly resulted from disease progression or unrelated adverse events. One patient (1.1% [95% CI, 0.0 to 6.1]) experienced a grade 2 IRR during shortened infusions; no grade ≥3 IRRs occurred. Most patients reported high satisfaction, and over 150 hours of outpatient infusion unit capacity were saved.
Conclusions:
Ten-minute pembrolizumab infusions are safe and well tolerated and enhance both patient satisfaction and outpatient efficiency.
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