Comparing the time spent in clinic by patients receiving, subcutaneous and intravenous formulations of cancer drugs: A pilot study

Background

Subcutaneous (SC) formulations of cancer-directed and supportive care drugs are associated with time savings relative to their intravenous (IV) formulations in clinical trials, but it is unclear if these time savings apply in routine practice.

Methods

We performed a retrospective study of adults with breast cancer treated at a single U.S. academic clinic site in 2024. We matched patients who received (1) SC trastuzumab/pertuzumab, or (2) SC denosumab, 1:1 to patients who received comparator IV formulations (IV trastuzumab/pertuzumab, or IV zoledronic acid, respectively) and had the same number and type of appointment(s) that day. We used Real-time location system (RTLS) badge data to calculate total time spent in the clinic and in the infusion area, and compared these between groups.

Results

Among 14 patient-days with SC trastuzumab/pertuzumab and 15 patient-days with SC denosumab matched 1:1 with their IV comparators, most days included other ambulatory services performed (10/14 for SC trastuzumab/pertuzumab, 14/15 for SC denosumab). For trastuzumab/ pertuzumab, the median infusion area time was 65 min for SC vs. 110 min for IV (median difference, 48 min, p < 0.003). The median total clinic time was 166 min for SC vs. 198 min for IV (median difference, 44 min, p = 0.206). For SC denosumab vs IV zoledronic acid, the median total clinic time was 99 min for SC vs. 110 min for IV (median difference, 19 min, p = 0.049).

Conclusion

Despite impressive time savings in clinical trials, SC trastuzumab/pertuzumab and SC denosumab offered only modest time savings compared with their IV counterparts when delivered in clinic.