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. 2025 Nov 26.
doi: 10.1007/s40487-025-00402-x. Online ahead of print.

Exploratory Analyses of Patient Preferences for Atezolizumab Subcutaneous Versus Intravenous from the IMscin002 Study in Patients with Non-Small Cell Lung Cancer

Margarita Majem  1 , Busyamas Chewaskulyong  2 , Zanete Zvirbule  3 , Ki Hyeong Lee  4 , Ernesto Korbenfeld  5 , Jaroslaw Kolb-Sielecki  6 , Amparo Yovanna Castro Sanchez  7 , Alberto Bustillos  7 , Luis Herraez-Baranda  7 , Xiaoyan Liu  8 , Sang-We Kim  9 , Federico Cappuzzo  10
Affiliations

Exploratory Analyses of Patient Preferences for Atezolizumab Subcutaneous Versus Intravenous from the IMscin002 Study in Patients with Non-Small Cell Lung Cancer

Margarita Majem et al. Oncol Ther. .

Abstract

Introduction: The primary analysis of IMscin002 (NCT05171777) demonstrated that most patients preferred atezolizumab subcutaneous (SC) administration over intravenous (IV) administration; we report patient preference according to baseline characteristics, mean injection duration, and cumulative number of SC injections at each center from IMscin002.

Methods: In this phase 2, randomized, open-label, crossover trial, patients aged ≥18 years, with EGFR/ALK wild-type tumors and either PD-L1+ (≥ 1%) resected non-small cell lung cancer (NSCLC) (stage 2, 3a, or selected 3b; AJCC 8th edition) with prior chemotherapy and no evidence of recurrence, or untreated PD-L1-high (≥ 50%) stage 4 NSCLC were eligible. Patients, randomized 1:1, received atezolizumab IV or SC for three cycles before switching to the alternative formulation for another three cycles. Patients chose a formulation for the continuation period after cycle 6.

Primary endpoint: patient preference for atezolizumab SC/IV.

Results: Among 179 patients randomized, demographics and characteristics were generally balanced between arms. Overall, 87/123 patients (70.7%) preferred atezolizumab SC, of whom 86.2% had a very/fairly strong preference compared with 69.2% of patients who preferred IV (n = 26/123, 21.1%). Patient preference for atezolizumab SC was independent of baseline characteristics and mean injection duration. A higher proportion of preference was seen in patients aged > 74 years (87.5%). A trend for a greater number of patients preferring atezolizumab SC over IV was seen in patients at centers where a higher number of cumulative injections (> 47 to ≤ 164) were administered before preference disclosure.

Conclusions: Most patients preferred atezolizumab SC regardless of baseline characteristics, mean injection duration, and cumulative number of SC injections. The trend for a stronger preference was higher among patients who preferred SC than those who preferred IV. Our findings suggest that the proportion of preference for atezolizumab SC over IV is highest in patients aged > 74 years, and that administrator's experience could be an important factor influencing patient preference.

Clinical trial registration number: NCT05171777.

Keywords: Atezolizumab; Intravenous; Non-small cell lung cancer; Patient preference; Subcutaneous.

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Conflict of interest statement

Declarations. Conflict of Interest: All authors report medical writing support for the present manuscript. Margarita Majem reports receiving grants from AstraZeneca and F. Hoffmann-La Roche; consulting fees from AstraZeneca, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, F. Hoffmann-La Roche, Helsinn Therapeutics, Janssen Oncology, Merck Sharp & Dohme, Novartis, Pfizer, Pierre Fabre, and Takeda; invited speaker for AstraZeneca, F. Hoffmann-La Roche, Helsinn Therapeutics, Merck Sharp & Dohme, and Pfizer; support for attending meetings and/or travel from AstraZeneca, F. Hoffmann-La Roche, Merck Sharp & Dohme Oncology, and Pfizer. Busyamas Chewaskulyong reports advisory role, local primary investigator, and fiduciary role in another board, society, committee or advocacy group for F. Hoffmann-La Roche. Zanete Zvirbule reports receiving honoraria from AstraZeneca, and travel support for attending meetings from AstraZeneca, F. Hoffmann-La Roche, and Merck Sharp & Dohme. Ki Hyeong Lee reports research funding from Merck Sharp & Dohme; speaker, consultancy, or advisory positions for AstraZeneca, Bristol Myers Squibb, Lilly, Merck Sharp & Dohme, Pfizer, Takeda, and Yuhan. Ernesto Korbenfeld reports being a principal investigator and owning shares in Centro Oncologico Korben; providing consultancy or advisory roles for Pfizer; honoraria from AstraZeneca. Jaroslaw Kolb-Sielecki reports receiving travel support for attending congresses from AstraZeneca and F. Hoffmann-La Roche; primary investigator for AstraZeneca, Bristol Myers Squibb, F. Hoffmann-La Roche, GSK, and Merck Sharp & Dohme. Amparo Yovanna Castro Sanchez is employed full-time at F. Hoffmann-La Roche and has stocks/shares in F. Hoffmann-La Roche. Alberto Bustillos is employed full-time at F. Hoffmann-La Roche and has stocks/shares in F. Hoffmann-La Roche. Luis Herraez-Baranda is employed full-time at F. Hoffmann-La Roche and has stocks/shares in F. Hoffmann-La Roche. Xiaoyan Liu is employed full-time at Genentech and has stocks/shares in F. Hoffmann-La Roche. Sang-We Kim reports advisory roles for Amgen, AstraZeneca, Boehringer Ingelheim, Janssen, Novartis, Takeda, and Yuhan; invited speaker for Amgen, Boehringer Ingelheim, Janssen, Novartis, and Takeda; research funding from Yuhan. Federico Cappuzzo reports receiving consultancy fees from Amgen, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, F. Hoffmann-La Roche, Galecto, ILLUMINA, Lilly, Merck Sharp & Dohme, Mirati Therapeutics, Novocure, OSE, Pharmamar, Pfizer, Sanofi, Takeda, and Thermofisher; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Amgen, AstraZeneca, Bayer, BeiGene, Bristol Myers Squibb, F. Hoffmann-La Roche, Galecto, ILLUMINA, Lilly, Merck Sharp & Dohme, Mirati Therapeutics, Novocure, OSE, Pfizer, Pharmamar, Sanofi, Takeda, and Thermofisher; participation on a Data Safety Monitoring Board or Advisory Board for Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, F. Hoffmann-La Roche, Galecto, ILLUMINA, Lilly, Merck Sharp & Dohme, Mirati Therapeutics, Novocure, OSE, Pharmamar, Pfizer, Sanofi, Takeda, and Thermofisher. Ethical Approval: This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice Guidelines. Written informed consent was obtained from all patients. Protocols were approved by the relevant institutional review boards at each study site.

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