Study explores future prospects for home-based cancer treatment

Exploring if giving atezolizumab under the skin and remote monitoring can alter cancer treatment.

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A new trial by Keck Medicine of USC will check if giving immunotherapy at home works as well as in the hospital. This trial aims to treat lung cancer that is not tiny cells. Immunotherapy aids the body’s defense against cancerous cells. It is usually administered at a hospital through a vein.

The goal of the trial is to determine whether a nurse can safely administer atezolizumab, a treatment for some forms of lung cancer, subcutaneously at home. In addition, wearable trackers for remote monitoring and telemedicine visits would be provided to patients. This trial may facilitate future home-based cancer care.

Jorge Nieva, MD, a medical oncologist and lung cancer specialist with Keck Medicine, a member of USC Norris Comprehensive Cancer Center and lead investigator of the clinical trial, said, “Many types of drugs are now being delivered subcutaneously at home for several conditions, and we hypothesize that this method of drug delivery can also be successful for cancer patients. Additionally, since COVID-19, we’ve learned that physicians have the digital tools to provide patients with excellent remote care.” 

Lung cancer is the second most common disease worldwide and the leading cause of cancer-related deaths worldwide; in the United States, 81% of cases are non-small cell lung cancer. Recently, immunotherapy has been approved to treat a variety of tumors, either on its own or in combination with chemotherapy or radiation therapy.

Shifting the administration of immunotherapy from hospitals to patients’ homes presents potential advantages, such as saving time and energy for travel. This would be particularly beneficial for severely ill patients who may feel more at ease in their familiar environment. 

This change may also make therapy more accessible to those who live in rural areas or have limited access to transportation. In addition, there are additional advantages to administering the drug subcutaneously as opposed to intravenously.

According to Nieva, treating patients subcutaneously is more efficient, secure, and comfortable than IVs, which may result in problems or infection. During the COVID-19 epidemic, a patient avoided visiting the hospital out of fear of contracting the virus, which led to their investigation of at-home cancer care. The patient later passed away. Nieva became an advocate for altering the way cancer care is provided.

The drug being tested, atezolizumab, stimulates the immune system to attack cancer cells. The FDA approved it in 2016 for advanced lung cancer and in 2021 for early-stage non-small cell lung cancer. In the trial, 37 eligible non-small cell lung cancer patients will receive at-home treatments administered by a visiting nurse every three weeks for one to two years. 

Under Nieva’s direction, researchers will perform telehealth visits and remotely monitor patients’ health indicators using digital tools. The study’s purpose is to evaluate patient compliance, satisfaction with remote care, and the viability of at-home treatment.

Nieva hopes the trial will help non-small cell lung cancer patients and others. Access to care can be improved, and healthcare disparities may be addressed by bringing healthcare to patients rather than the other way around. The study may open the door for at-home treatments for different cancers if it establishes the safety and viability of immunotherapy for lung cancer. 

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