What cancer patients can expect from oncology infusion and injection therapies

When chemotherapy ends for an oncology patient, the nausea and hair loss may ease. But a new phase of treatment lies ahead, often an infusion or injectable immunotherapy given every few weeks. Finishing one phase of your care plan is over, but you may still have questions or concerns about this new phase you’re about to enter. 

If that's where you are, you're not alone, and you don't have to figure out how this next phase works by yourself. This post walks through what infusion and injectable therapy for cancer patients actually involves, including:

• What it is.
• Which medications are typically given this way.
• What a treatment day looks like.
• What side effects to expect.
• Why more oncology patients are being treated outside a hospital altogether.

Leap and oncology treatment

Leap is an infusion and injectable therapy provider built around oncology-specific safety standards, including guidance from the Oncology Nursing Society (ONS) and the American Society of Clinical Oncology (ASCO). 

Leap's clinical team, including oncology-trained nurses and pharmacists, coordinates each patient's care directly with the oncologist already managing their treatment.

What is infusion and injectable therapy?

Infusion therapy is a way to deliver medication directly into the body over a set period of time, most often through a vein. 

Many cancer treatments, including immunotherapies such as Keytruda and Opdivo, are biologics, which are large, complex molecules built from living cells rather than manufactured as a simple chemical compound. A pill can't survive digestion intact at that size and complexity, so the medication has to reach the body another way.

Some infusion and injectable therapies are given alongside chemotherapy or following chemotherapy. 

What is an infusion versus an injection?

This is when the terms infusion and injection can start to blur. 

• An infusion is a slow, controlled delivery into a vein, typically through a peripheral IV or a port, lasting anywhere from a few minutes to several hours. 
• An injection delivers medication under the skin (subcutaneous) or into a muscle, usually in a few minutes. 

Some cancer drugs now come in both forms. Darzalex, for example, has a traditional IV infusion version and a newer subcutaneous injection version, Darzalex Faspro, that delivers the same medication in a fraction of the time. Knowing which one a treatment plan calls for changes what an appointment looks like.

Where this happens has expanded too. Cancer infusion has traditionally meant a hospital outpatient department, but infusion therapy in the home or at a freestanding infusion center are both potentially options for a patient. 

What types of cancer are treated with infusion therapy?

Infusion for cancer treatment spans both solid tumors and blood cancers (wherever immunotherapy or targeted biologic therapy is part of the standard of care). That includes many of the most common diagnoses, such as: 

• Lung cancer
• Breast cancer
• Kidney cancer
• Skin cancers treated with checkpoint inhibitors
• Blood cancers like multiple myeloma and lymphoma treated with targeted antibody therapies

The therapies best suited for home infusion are generally single-agent, maintenance-phase immunotherapy and supportive care. These would typically be the types of medications used once a patient's disease and treatment plan are already established. 

What types of medications are being infused

Here’s a closer look at a few of the medications that oncology patients receive through infusion. Please note that this is not a comprehensive list. 

Keytruda infusion and immunotherapy

Keytruda (pembrolizumab) is one of the most widely used cancer immunotherapies, and it works differently than traditional chemotherapy. Rather than directly killing cancer cells, Keytruda is a checkpoint inhibitor. It blocks a protein that cancer cells use to hide from the immune system, so the body's own immune response can find and attack the tumor.

Keytruda infusion is typically given on a maintenance schedule, spaced weeks apart, once the initial course of therapy has been established with a patient's oncologist. That maintenance-phase stability is exactly the profile that makes a therapy like Keytruda a realistic candidate for care outside a hospital setting.

Keytruda is also available as a subcutaneous injection too. Keytruda Qlex delivers the same medication under the skin in a matter of minutes, as an alternative to the original IV infusion. The choice between the two comes down to a patient's specific treatment plan and their oncologist's recommendation.

Darzalex Faspro injection

Darzalex Faspro is the subcutaneous injection version of daratumumab, a targeted antibody therapy used for multiple myeloma. Unlike the original IV version of Darzalex, which can take hours to infuse, Darzalex Faspro is delivered as an injection under the skin in a matter of minutes.

That difference matters beyond convenience. A shorter administration time can mean:

• Less time in a chair.
• Less disruption to a workday.
• More flexibility in where the medication can be given. 

Opdivo and other checkpoint inhibitors

Opdivo (nivolumab) works through the same checkpoint-inhibitor mechanism as Keytruda and follows a similar maintenance-phase pattern once initial treatment is established. Other immunotherapies in this family are following the same trajectory, including stable dosing schedules, established safety profiles, and options for where treatments can be administered.

Opdivo has its own subcutaneous version. Opdivo Qvantig allows for delivery of the medication as an injection instead of an IV infusion.

Oncology infusion also covers a category of supportive therapies that don’t treat the cancer itself, but can contribute to a patient’s care. They include: 

• Bone-modifying agents like Xgeva and Prolia.
• Hematopoietic growth factors, such as pegfilgrastim products, that support the body's blood cell production during treatment. 
• Iron infusions for treatment-related anemia. 

How medications are administered via infusion or injection

A typical infusion appointment follows a similar rhythm regardless of the specific drug, though the details vary by treatment plan and should always come from a patient's care team.

1. Labs are drawn and reviewed to confirm it's safe to proceed with that day's dose. 
2. If premedication is part of the plan, it's given before the main treatment starts, and a prescriber or infusion nurse will explain exactly what that involves for that specific therapy. 
3. Then comes IV or port access for an infusion, or the injection itself for a subcutaneous therapy like Darzalex Faspro. The medication is administered over the appropriate time, whether that's a few minutes for an injection or several hours for a longer infusion. 
4. Finally, there's an observation period to watch for any immediate reaction before the appointment ends.

Many oncology patients already have a port implanted, such as a small device placed under the skin, that connects to a large vein. A port means a nurse doesn't have to find a new vein at every visit, which is different from the peripheral IV (PIV) used for a single appointment. Which one applies depends on the treatment plan and the oncologist's recommendation.

What side effects might look like

Every cancer treatment carries some possibility of side effects, and infusion therapy is no exception. Fatigue is common after treatment. Site reactions, some redness, swelling, or soreness where the IV or injection was given, can happen and usually resolve on their own. 

There is also the possibility of an infusion reaction, though it’s rare. A response to the medication that can range from mild to more serious. That possibility is exactly why trained clinical staff are present for every infusion appointment, watching for early signs and ready to respond. Typically, patients who have already tolerated their medication in a monitored setting carry lower risk than someone receiving a brand-new therapy for the first time.

This article is educational, not medical advice for any individual situation. What side effects to expect, and how to manage them, is a conversation for a prescriber or a Leap Care Guide.

Is oncology infusion care outside of a hospital safe? 

For the right patient and the right treatment, research shows that it is. For those who have been identified as candidates for care outside of a hospital, there are real benefits. But not every cancer patient is a candidate for infusion outside a hospital. 

• Patients considered for care outside a hospital setting typically have already been through the higher-risk early doses of their treatment and tolerated the medication well. New patients and higher-risk regimens stay in a monitored clinical setting.
• An immunocompromised patient sitting in a hospital infusion setting potentially faces higher infection risk because they’re exposed to more of the pathogens circulating through that building than a patient receiving the same treatment at home. 
• With Leap, a dedicated Care Guide can be an important support system for the patient’s care journey. A Care Guide is a single point of contact who coordinates across a patient's oncologist, infusion nurse, and insurance, quarterbacking a treatment journey that otherwise involves a lot of different people.
• Site-of-care and time-of-care flexibility by receiving infusion therapy at home can save patients valuable time otherwise spent skipping work to receive care, driving to and from the nearest hospital to receive care, and missing out on family time for care. 

Why should I choose in-home treatment? 

There are many potential benefits to receiving treatment in the home, including:

• Time savings with care on your terms. No more commuting, parking, or sitting in a waiting room. Treatments work around your schedule and occur in an environment that’s familiar and comfortable to you.
• Personalized care. Your nurse is focused on you for the whole visit. They get to know you over time, and can notice what’s working well and what isn’t.
• Peace of mind. For members with weakened immune systems, staying out of crowded clinics can provide extra comfort and peace of mind.
• The same standard of care. Treatments are delivered by a licensed nurse and held to the same clinical safety standards you’d expect anywhere else.

Because in-home infusions more naturally fit into your life, many members find it easier to stay on track with a treatment plan that can last months or years.

Ultimately, the decision to pursue in-home treatment is a personal one, and should be considered with your unique preferences and situation in mind.

What to expect if you start infusion therapy through Leap

If an oncologist determines a patient is a good candidate, here's roughly what the process looks like. 

1. The prescriber sends the treatment plan to Leap. 
2. A dedicated Care Guide is assigned to coordinate care and answer questions along the way. 
3. If the first dose calls for a monitored setting, that happens first, with later doses transitioning to home or a nearby Leap-associated infusion center once the patient and care team are ready. 
4. The Care Guide stays in touch with the prescriber's office throughout, so treatment notes and any clinical updates go back to the people already managing that patient's care.

The oncologist remains in charge of the treatment plan the whole time. Leap coordinates the logistics within that plan.

Find out if you’re eligible

Nobody chooses a cancer diagnosis, and nobody should have to become a full-time logistics coordinator on top of it. If infusion therapy through Leap might be an option for a treatment plan, checking eligibility takes just a few minutes.

Do you think at-home infusion therapy is right for you? Check to see if you’re eligible for Leap.