CN8 - Revolutionizing oncological care: Successful implementation of home-based antineoplastic treatments

Background

The SARS-CoV-2 pandemic led many patients to face the difficult decision of weighing the risks and benefits associated with traveling to the hospital for cancer treatment. Driven by this context and motivated by the growing demand for safer and more convenient alternatives, we proposed expanding the administration of low-risk neoplastic treatments to the ambulatory setting. This program has been unprecedented in the Autonomous Community of Cantabria thus far, as there is currently no service that administers chemotherapy outside specialized units in the region's reference hospitals.

Methods

A pilot study was conducted to assess the safety and feasibility of administering low-risk antineoplastic treatments at home at the Marqués de Valdecilla University Hospital, in the city of Santander-Cantabria. The study sample consisted of 139 participants between November 2020 and April 2024. For a patient to be selected to receive treatment at home, they had to meet the following inclusion criteria: firstly, be actively undergoing treatment with low-risk antineoplastic drugs, either subcutaneously or intravenously after the third dose; have a residence in Santander and within a 10-kilometer radius; be at home accompanied by a caregiver between 8:00 and 14:00 on the day of treatment; be able to read and write, or alternatively, have a family member or caregiver available to complete satisfaction questionnaires if necessary. Patients were included in the study only after receiving all the information and providing their consent to participate.

Results

A total of 1,334 cycles were infused in 139 patients from December 2020 to January 2024. The average age of the treated population was 65 years, with 37% being male (n=52) and 63% female (n=87). Breast cancer was the most treated pathology at home (n=59), followed by lung cancer (n=35) and colon cancer (n=12). The most administered drug was trastuzumab (n=47), followed by Pembrolizumab (n=32), Bevacizumab (n=19), and Atezolizumab (n=17). During the pilot program, no adverse infusion reactions were recorded at home.

Conclusions

This project represents a step forward in optimizing oncological care, although further exploration of new ways to improve our patients' treatment experience is still needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Instituto de Investigación Valdecilla (IDIVAL).

Funding

IDIVAL, FUPOCAN, AstraZeneca, MSD, Bristol Myers Squibb.

Disclosure

All authors have declared no conflicts of interest.