Vol 20, No 2 (2024)
Research paper
Published online: 2023-07-10

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Home-based treatment with subcutaneous trastuzumab: safe and acceptable not only during a pandemic — final analysis of the RWD project ‘FlexCare’

Barbara Radecka12, Joanna Hudała-Klecha12, Dariusz Sawka3, Jolanta Sarga2, Bożena Noworolska2, Grażyna Susczyk2, Jolanta Sawicka3, Elżbieta Duda2, Natalia Obruśnik2, Patryk Zając24
Oncol Clin Pract 2024;20(2):117-123.

Abstract

Introduction. Trastuzumab shows similar efficacy and safety profile regardless of IV or SC administration. Subcutaneous administration enables reduction of treatment costs and time as well as equipment savings and is more convenient for both patients and healthcare providers. In Poland, home-based programs of treatment with biological drugs are already implemented; however, to date they do not include trastuzumab in BC patients. The project aimed to evaluate the organizational and therapeutic procedures related to home-based treatment with subcutaneous trastuzumab and satisfaction of patients and healthcare providers based on RWE. 

Material and methods. Early HER2(+) BC patients treated with trastuzumab were enrolled in the study. Monitoring and duration of treatment were consistent with the summary of product characteristics (SmPC) and reimbursement rules. The first 3–6 doses of trastuzumab were administered at the cancer center, followed by home doses. Medical visits took place every 3 months. The data were analyzed using descriptive statistics. A positive opinion of the Bioethics Committee was obtained. 

Results. Twenty patients participated in the project. The median age was 59 years (36–72 years). The average distance from the place of residence to the hospital was 24 km (2–65 km). We administered 232 doses, with an average of 11.6 doses per patient (range 6–14). The tolerance of trastuzumab was good and consistent with the SmPC. The average duration of a nurse’s stay at home was 60 minutes. Almost all patients (19/20) appreciated the possibility of saving time and continuing their professional work as well as avoiding crowds and the risk of infection in the hospital. Two patients felt that nurse visits violated their privacy. No logistical or technical problems were observed. 

Conclusions. Home-based treatment with subcutaneously administered trastuzumab is safe and easy to organize, positively perceived by both patients and nurses. It can be particularly important for disabled patients who have difficulty reaching the hospital, as well as for professionally active patients.

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