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Under-the-skin versions of atezolizumab, nivolumab and pembrolizumab take minutes rather than an hour and need no infusion chair, so they can be given by a nurse near home, cutting facility fees and travel.
The FDA approved subcutaneous atezolizumab (2024), nivolumab (2024) and pembrolizumab (2025), each with hyaluronidase to allow a large-volume injection over a few minutes. The clinical benefit is equivalent; the economic benefit depends on where the injection is given. Delivered in a community clinic or by a home-visiting nurse, the injection avoids hospital facility fees, infusion-suite capacity and long journeys. Payment rules that require an infusion setting, and the drug's Part B status, currently blunt the saving.
For colon cancer that is mismatch-repair deficient (about 10-15% of colon cancers, more in older patients), a single short course of immunotherapy before surgery is now a reasonable standard and is far more effective than chemotherapy, which has little effect in this subtype. It requires testing every colon cancer for mismatch repair at diagnosis, before surgery. Whether some patients can safely skip surgery, as in dMMR rectal cancer, is the next question.
Most patients with newly diagnosed advanced non-squamous lung cancer that lacks a targetable mutation should receive chemotherapy plus pembrolizumab; those with PD-L1 of 50% or more may reasonably receive pembrolizumab alone. About one in five patients is alive at five years, compared with roughly one in ten with chemotherapy alone. Patients with EGFR or ALK alterations were excluded and should have targeted therapy first.
With CheckMate 057 this trial ended docetaxel's role as the default second-line treatment in lung cancer and gave the first phase 3 proof that PD-1 blockade extends life in a common carcinoma. Its PD-L1-independent benefit in squamous disease still shapes how the biomarker is used.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Not enough oncologists, nurses, pathologists, physicists, Fragmented care and guideline gaps.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Prices and value, Nivolumab.
Shares Prices and value, Most of the world has almost no cancer care, Nivolumab, Pembrolizumab.
Shares Prices and value, Most of the world has almost no cancer care, Nivolumab, Pembrolizumab.
Shares Prices and value, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.
Shares Prices and value, Nivolumab, Pembrolizumab.
Shares Prices and value, Most of the world has almost no cancer care, Pembrolizumab.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, Prices and value, Most of the world has almost no cancer care, Nivolumab.