# Home administration of selected chemotherapy and immunotherapy for older and frail patients

Source: https://onco.cc/ideas/idea-acc-home-chemotherapy-older-patients/  
OnCo record `idea-acc-home-chemotherapy-older-patients` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

For frail older patients, the journey to hospital can be the hardest part of treatment. Nurses can safely give some cancer treatments at home, which may help more people complete their course.

## Summary

Home chemotherapy programmes exist in several countries for low-risk regimens and for subcutaneous formulations of antibodies, with high patient satisfaction and safety. For older and frail patients, travel and waiting are major causes of missed doses and early discontinuation. Extending home delivery to this group, with remote monitoring and clear escalation routes, could improve completion and quality of life; payment models are the main barrier.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Home administration for eligible patients over 75 will increase treatment completion by at least 15 percentage points and reduce patient-reported treatment burden, with equivalent safety.
- Rationale: Home delivery of complex therapies (dialysis, parenteral nutrition, IV antibiotics) is safe and preferred by patients; oncology has lagged for institutional rather than clinical reasons.
- Proposed test: A randomised trial of home versus clinic administration for defined regimens in patients over 75, with completion, adverse events, quality of life, and cost as endpoints.
- Maturity: being-tested-at-scale
- Actor: payer

## Sources

- Bottleneck evidence (Older and multimorbid patients are excluded and undertreated): Mohile et al., Evaluation of geriatric assessment and management on toxic effects of cancer treatment (GAP70+, Lancet 2021): https://doi.org/10.1016/S0140-6736(21)01789-X

## Connected records

- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/)

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