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Subcutaneous (SC) formulations of immunotherapy offer a clinically validated alternative to intravenous (IV) administration and may facilitate more efficient, patient-centered models of cancer care delivery. However, the organizational, economic, and governance implications of this transition remain insufficiently explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a mixed-methods analysis integrating four components: (1) a structured narrative review of clinical evidence regarding SC immune checkpoint inhibitors, including pharmacokinetics, efficacy, safety, and patient-reported outcomes; (2) an economic evaluation including cost-effectiveness and return-on-investment analyses; (3) benchmarking of national and international decentralized oncology care models; and (4) cross-sectional surveys of healthcare professionals (n\u2009=\u200984) and patients receiving immunotherapy (n\u2009=\u200976). Based on these findings, a hub-and-spoke care delivery framework supported by digital health tools was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across tumor types, SC immunotherapy demonstrated pharmacokinetic bioequivalence to IV formulations, with comparable efficacy and safety profiles. Treatment time was reduced by approximately 85\u201390%, resulting in improved patient-reported experience and reduced cumulative treatment burden. Adoption of SC immunotherapy was associated with up to 40% reduction in oncology day hospital occupancy and an estimated net annual saving of approximately \u20ac1,410 per patient. Both patients and healthcare professionals supported decentralized administration for selected clinically stable patients; however, acceptance was strongly dependent on preservation of oncologist-led care, strict patient selection, digital monitoring, and clearly defined escalation pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SC immunotherapy is a clinically effective and safe alternative to IV administration whose principal value lies in enabling selective decentralization of oncology care rather than simple logistical convenience. When implemented within a structured hub-and-spoke model that preserves medical oncology leadership, SC immunotherapy may improve patient experience, optimize healthcare resources, and strengthen long-term health system sustainability without compromising safety or continuity of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12094-026-04393-7","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:56:13Z","timestamp":1780926973000},"page":"5581-5598","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subcutaneous immunotherapy as a catalyst for decentralized, oncologist-led cancer care: a mixed-methods analysis"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7556-7608","authenticated-orcid":false,"given":"Eva","family":"Mu\u00f1oz-Couselo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lostes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pretelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Peir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Barrub\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Bayona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"4393_CR1","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1126\/science.aar4060","volume":"359","author":"A Ribas","year":"2018","unstructured":"Ribas A, Wolchok JD. 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The authors declare the following financial interests\/personal relationships which may be considered as potential competing interests: Eva Munoz Couselo reports was provided by hospital vall hebron. Eva Munoz Couselo reports a relationship with hospital vall hebron that includes: board membership, consulting or advisory, speaking and lecture fees, and travel reimbursement.\u2014EM-C received consulting fees from Amgen, Bristol Myers Squibb, Menarini, Merck Sharp & Dohme, Pierre Fabre, Novartis, Regeneron, and Sanofi; presentation payment\/honoraria from Bristol Meyers Squibb, Merck Sharp & Dohme, Novartis, and Pierre Fabre; payment for expert testimony from Bristol Meyers Squibb and Merck Sharp & Dohme; and travel support from Merck Sharp & Dohme and Pierre Fabre\u2014XB, JB & MP have nothing to declare. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki (1964) and its subsequent amendments. The study protocol, including the administration of surveys to healthcare professionals and patients, was reviewed and approved by the Institutional Review Board\/Ethics Committee of Vall d\u2019Hebron University Hospital (Barcelona, Spain). According to institutional policies, formal ethics committee approval was waived due to the anonymous and non-interventional nature of the survey. All participants provided informed consent prior to inclusion in the study. Participation was voluntary and responses were collected anonymously. No identifiable personal or clinical data were recorded, ensuring full protection of participant confidentiality and privacy. All procedures involving human participants were performed in accordance with applicable institutional and national ethical standards. No information that could disclose the identity of individual participants is included in this manuscript.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}