How Subcutaneous Immunotherapy Could Ease Strain on Oncology Nurses

As more patients with cancer receive immune checkpoint inhibitors for longer periods, moving administration from a 30-minute intravenous (IV) infusion to a subcutaneous injection lasting a few minutes may help oncology teams absorb growing patient volumes, according to Irati Rodríguez Matesanz, MSN, FNP-BC, a nurse practitioner in breast oncology at City of Hope Atlanta in Newnan, Georgia.

Rodríguez Matesanz chaired "Oncology Nursing Perspectives on Subcutaneous Immunotherapy: Practical Considerations for Patient Care," an MSD-sponsored satellite symposium held October 24, 2026, at the European Oncology Nursing Society (EONS) congress in Madrid, Spain.¹ She is also co-chair of the EONS Early Career Nurses Working Group.^1,2

Why are oncology nurses looking at subcutaneous immunotherapy now?

In an interview with Oncology Nursing News prior to the symposium, Rodríguez Matesanz described a care system under growing pressure.

"I think that we see the demands of more patients being diagnosed with cancer, longer therapies, more patients receiving immunotherapies for a longer period of time, sometimes for years at a time," she said. "So of course that puts a strain in the system."

Much of nursing care stays the same regardless of route, she noted. "And I think that there are some things that don't change, like assessing these patients, talking to them, evaluating them," Rodríguez Matesanz said. "One of the things that we can affect is the way in which we administer those medications."

How much time can a subcutaneous injection save?

"If we can make administering a treatment quicker in this way, changing it from a 30-minute infusion to a 2- to 3-minute injection, that definitely saves the patients and the nurses time," she said. "We need that quick turnover and capacity, but overall it should liberate the system slightly or at least make it more feasible to assume the large volumes."

In the United States, the FDA approved pembrolizumab and berahyaluronidase alfa-pmph (Keytruda Qlex) on September 19, 2025, for adult and pediatric (12 years and older) solid tumor indications of IV pembrolizumab, at 395 mg every 3 weeks or 790 mg every 6 weeks.³ The European Commission later approved subcutaneous pembrolizumab for all adult indications of the IV formulation.⁴

The approval was supported by the phase 3 3475A-D77 trial (NCT05722015), which randomly assigned 377 patients with treatment-naive metastatic non-small cell lung cancer 2:1 to subcutaneous or IV pembrolizumab, each with platinum doublet chemotherapy.^3,5 The subcutaneous formulation met its pharmacokinetic primary end points, with objective response rates of 45% vs 42%, respectively.^3,5 Median injection time was 2.0 minutes (range, 1-12), and weighted mean chair time was 59.0 minutes vs 117.2 minutes with IV administration.⁶

What did the EONS symposium cover?

The program addressed what changes at the bedside when moving from IV to subcutaneous delivery; a nurse playbook for preparing, administering, and monitoring subcutaneous immunotherapy; patient experiences; and a nurse panel on implementing these services in hospital and community settings.¹

The shift reflects a broader move to deliver cancer therapy outside the infusion chair, including the recent approval of subcutaneous isatuximab-irfc (Sarclisa Escena) via an on-body injector.⁷

What are the key takeaways for oncology nurses?

• Keep core assessment in place: Evaluating and talking with patients before each dose does not change with the route of administration.
• Plan for capacity: Shorter administration can free chair and nursing time, but scheduling still needs quick patient turnover.
• Educate patients: Response rates were comparable between subcutaneous and IV pembrolizumab in 3475A-D77.3,5
• Know the dosing options: The every-3-week and every-6-week schedules may help align visits with patient needs.³

References

1. Oncology nursing perspectives on subcutaneous immunotherapy: practical considerations for patient care. Satellite symposium sponsored by MSD. Presented at: European Oncology Nursing Society Congress 2026; October 24, 2026; Madrid, Spain.
2. Irati Rodríguez-Matesanz, MSN, FNP-BC. City of Hope. Accessed October 26, 2026. https://www.cancercenter.com/physician-directory/irati-rodriguez-matesanz
3. FDA approves pembrolizumab and berahyaluronidase alfa-pmph for subcutaneous injection. FDA. September 19, 2025. Accessed October 26, 2026. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-pembrolizumab-and-berahyaluronidase-alfa-pmph-subcutaneous-injection
4. Wahner A. Subcutaneous pembrolizumab approved in EU for all adult indications. OncLive. December 1, 2025. Accessed October 26, 2026. https://www.onclive.com/view/subcutaneous-pembrolizumab-approved-in-eu-for-all-adult-indications
5. Felip E, Rojas CI, Schenker M, et al. Subcutaneous versus intravenous pembrolizumab, in combination with chemotherapy, for treatment of metastatic non-small-cell lung cancer: the phase III 3475A-D77 trial. Ann Oncol. 2025;36(7):775-785. doi:10.1016/j.annonc.2025.03.012
6. Hoyt B. Subcutaneous pembrolizumab is FDA approved, slashes chair time. Oncology Nursing News. September 19, 2025. Accessed October 26, 2026. https://www.oncnursingnews.com/view/subcutaneous-pembrolizumab-is-fda-approved-slashes-chair-time
7. Biese A. On-body injectors: what oncology nurses and PAs need to know. Oncology Nursing News. October 14, 2026. Accessed October 26, 2026. https://www.oncnursingnews.com/view/on-body-injectors-what-oncology-nurses-and-pas-need-to-know