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NHS England will be the first health system in the world to offer the subcutaneous injection of the cancer treatment atezolizumab to patients “within weeks”, it has announced.
In a statement published on 29 August 2023, NHS England said the new formulation of the drug will reduce treatment times by up to 75%, while cancer specialists have told The Pharmaceutical Journal that the treatment will also ease pressures on pharmacy aseptic units.
Atezolizumab — a monoclonal antibody indicated for a range of cancers, including bladder, breast, liver and lung cancer — currently takes around 30 minutes to administer through IV infusion.
However, as a subcutaneous injection, the treatment can be administered in seven minutes.
In England, approximately 3,600 patients are treated with atezolizumab annually, with the majority expected to switch to the faster injection, the statement said.
However, NHS England added that those receiving IV chemotherapy in combination with atezolizumab “may remain on the transfusion”.
“Within weeks, hundreds of eligible patients being treated with atezolizumab are set to have their experience improved by switching to the swifter and more comfortable under the skin (or subcutaneous) injection — freeing up valuable time for NHS cancer teams,” the statement said.
Commenting on the announcement, Emma Foreman, vice chair of the British Oncology Pharmacy Association (BOPA), said: “This new formulation has the potential to ease capacity in a number of ways, not just through reduced administration time.
“With appropriate risk assessment, [atezolizumab] may be drawn up in [non-aseptic] clinical areas, releasing capacity in pharmacy aseptic units. This will facilitate ‘closer-to-home’ administration via homecare and outreach services,” she said.
A report on the results of a survey of IV systemic anti-cancer therapy services in the UK, published in September 2022, found that cancer treatments were delayed owing to staffing issues and aseptic unit capacity, with BOPA concluding that the services are “approaching a crisis point”.
Alexander Martin, a consultant oncologist at West Suffolk NHS Foundation Trust, said: “This is great news for both patients and clinicians. We welcome any new initiative that brings speedier treatment to patients and gives them more comfortable care.
“This approval will not only allow us to deliver convenient and faster care for our patients, but will enable our teams to treat more patients throughout the day.”
The launch of subcutaneous atezolizumab follows the successful introduction of Phesgo (trastuzumab/pertuzumab; Roche) — a single injection for breast cancer — in April 2021, which has benefited thousands of patients by cutting treatment times down from hours to minutes, increasing patient uptake in the NHS.
Peter Johnson, national director for cancer at NHS England, said: “Maintaining the best possible quality of life for cancer patients is vital, so the introduction of faster under-the-skin injections will make an important difference.”
