Current practices, challenges, and future directions in subcutaneous oncology monoclonal antibody delivery: a...

Subcutaneous oncology monoclonal antibodies (SCOmAbs) offer significant benefits compared to intravenous formulations, but little has been published on real-world preparation and administration practices with these products.

This qualitative study examined 30 participants (10 patients, 10 nurses, 10 pharmacists/pharmacy technicians) across US infusion centers via in-depth interviews covering current practices, pain points, device integration potential, projected impact of increased SCOmAb adoption, and perspectives on home administration.

Findings revealed considerable variability in SCOmAb preparation and administration practices. Notable deviations from expected workflows included bedside preparation by nurses, use of syringe pump modules, and one case of patient self-administration at home. Administration challenges included ergonomic difficulties during manual syringe injection, with nurses reporting physical discomfort and substantial workflow impact from being tethered to patients during delivery. Most patients expressed interest in home administration for time savings and flexibility, though concerns about training and safety were common.

Though drawn from a small US sample, these hypothesis-generating findings suggest developers should consider how next-generation product presentations might minimize identified pain points and enable safe transition to home self-administration. Delivery device integration may address current challenges but requires careful consideration of facility infrastructure, workflow impact, and patient training requirements.