At-home subcutaneous atezolizumab for non-small cell lung cancer: a prospective, single-arm phase II feasibility study

PURPOSE: Frequent in-clinic cancer treatment can be burdensome, particularly for older adults and patients with limited mobility. This study aimed to assess the safety, feasibility, and patient experience of at-home subcutaneous (SC) atezolizumab injection administration in patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: This feasibility study included five patients with NSCLC treated with atezolizumab SC injections (1,875 mg every 21 days). The first three treatment cycles were administered in clinic, followed by nurse-administered home treatment. Patients underwent routine laboratory testing, telehealth visits, and standard disease monitoring. Safety, injection timeliness, treatment compliance, and patient satisfaction were evaluated over a total of 70 treatment cycles. RESULTS: Of 70 total SC injections, 65 (93%) were delivered on time. No delays were attributable to atezolizumab SC administration. Two of five patients (40%) experienced an adverse event. Home administration required a shorter measured administration duration than in-clinic treatment (42.3 vs. 86.7 minutes). Digital monitoring engagement was limited. Mean Likert scores showed high overall satisfaction with drug administration (3.3/4) and preference for subcutaneous over intravenous administration (3.2/4). CONCLUSION: At-home atezolizumab SC administration was feasible in this small feasibility study and was associated with high patient satisfaction and shorter measured administration time. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier is NCT05340309.