IV vs Subcutaneous: Clinical Considerations

EP: 1.The Shifting to Subcutaneous Oncology: Recent FDA Approvals

EP: 2.Subcutaneous Value: Efficiency and Access

EP: 3.Workflow Wins: Scheduling and Pharmacy Impact

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EP: 4.IV vs Subcutaneous: Clinical Considerations

When deciding whether to use subcutaneous (SubQ) or intravenous (IV) therapies, clinicians must weigh several clinical and practical factors. One of the first considerations is the type of cancer being treated and whether a SubQ formulation is available and approved for that indication. In cases such as multiple myeloma, where drugs such as daratumumab and bortezomib are available in SubQ form, the switch is often clear-cut due to benefits such as a shorter administration time, reduced need for infusion ports, and lower risk of adverse effects such as peripheral neuropathy. Conversely, in aggressive lymphomas treated with regimens such as R-CHOP, IV administration may still be preferred for its rapid action and close patient monitoring.

Clinical decisions also rely on supporting data around the efficacy and safety of SubQ vs IV formulations. While cost isn’t currently a major driver in these decisions, patient lifestyle and preference play an increasingly important role. For example, patients who work full-time or manage demanding schedules may favor SubQ options that reduce their time in the clinic. These patient-centered benefits can translate into improved quality of life during treatment and potentially better treatment adherence.

When it comes to adherence and patient preference, SubQ therapies are generally favored. Studies and real-world observations show that more than 90% of patients prefer SubQ delivery when given the choice, largely due to its convenience and speed. Most patients who make the switch tend to stick with it. However, a small subset experiences anxiety about visible or prolonged injections, especially for high-volume doses, and may prefer the familiarity of IV through a port. As SubQ options expand, understanding both clinical appropriateness and individual patient needs will be essential to optimizing cancer treatment delivery and outcomes.