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NHS 'World First' Cancer Injection Roll-Out 

Hundreds of cancer patients will be offered a subcutaneous cancer injection that can reduce treatment time by up to 75% in a rollout that NHS England described as a "world first".

Patients being treated with the life-extending anti-PD-(L)1 immunotherapy drug atezolizumab (Tencentriq, Roche) currently receive it intravenously in hospital. However, administration of the treatment usually takes around 30 minutes and for some patients, such as those for whom venous access is difficult, as long as an hour.

MHRA Approves Subcutaneous Formulation

Following approval of the new subcutaneous formulation by the Medicines and Healthcare products Regulatory Agency (MHRA), the treatment option will be made available more widely. "Now and within weeks, hundreds of eligible patients being treated with atezolizumab are set to have their experience improved by switching to the swifter and more comfortable subcutaneous injection," NHS England said.

Professor Peter Johnson, NHS England's national director for cancer, said that the "world-first introduction of this treatment will mean that hundreds of patients can spend less time at the hospital and will free up valuable time in NHS chemotherapy units".

Atezolizumab is used to treat a number of cancers including those of the lung, breast, liver, and bladder.

The subcutaneous version of the drug (Tencentriq SC) is co-formulated with Halozyme's recombinant human hyaluronidase enzyme, rHuPH20. Using its ENHANZE drug delivery technology, subcutaneous treatment takes approximately 7 minutes.

Faster, More Convenient, Less Painful

The approval was based on clinical data from the Phase IB/III IMscin001 study, which showed comparable levels of Tecentriq in the blood when administered subcutaneously, and a safety and efficacy profile consistent with the intravenous formulation. 

Most cancer patients preferred to receive their treatments via subcutaneous delivery instead of intravenous infusion because took less time, was easier, and crucially, because it was less uncomfortable. 

Dr Alexander Martin, consultant oncologist at West Suffolk NHS Foundation Trust, commented that the announcement from the MHRA was "great news" for both patients and clinicians. "This approval will not only allow us to deliver convenient and faster care for our patients," he underlined, "but will enable our teams to treat more patients throughout the day."

NHS England anticipated that the majority of the approximately 3600 patients starting treatment of atezolizumab annually in England would switch onto the time-saving injection. However, it counselled that if a patient was receiving intravenous chemotherapy in combination with atezolizumab, they might continue to receive the drug intravenously.

The faster treatment came at no extra cost to the NHS, according to NHS England, because of an existing commercial deal negotiated between NHS England and drug manufacturer, Roche.

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