Systematic literature review of intravenous versus subcutaneous administration of oncology therapies: A clinical, economic and patient perspective

Subcutaneous (SC) formulations of oncology therapies offer a potentially less time-consuming and more convenient alternative to intravenous (IV) administration. However, exploring the potential benefits of SC over IV administration from a broader perspective is necessary to understand the larger-scale impact. In this systematic literature review (SLR), we evaluated the efficacy, pharmacokinetics/pharmacodynamics (PK/PD), safety, and patient and healthcare provider (HCP) preference for SC/IV oncology therapies, along with differences in patient outcomes, costs, and time requirements. The SLR was conducted in January 2019 and updated in May 2023, and included 169 publications. Studies providing comparative results between IV and SC formulations regarding clinical, economic, and patient outcomes were included. The focus was anticancer therapies for which both IV and SC formulations are being developed in phase 3 clinical trials, or are regulatory approved. SC administration was associated with savings in HCP time and patient chair time. Direct and indirect cost-savings were also observed. Increased treatment satisfaction and patient/HCP preference was reported with SC administration, as was improved caregiver productivity. The relative tolerability of SC and IV formulations for oncology drugs was similar; however, a higher incidence of injection-site reactions was reported with SC administration. Overall survival, PK/PD, and overall response rate results were comparable between IV and SC administration. This SLR demonstrates that SC and IV administration had comparable efficacy, PK/PD, and tolerability profiles, with SC administration associated with cost and time savings, and generally preferred by patients and HCPs. Therefore, SC administration of oncology therapies may offer advantages over IV administration.