IMS 2025: Enhancing Efficiency and Safety with OBI in Oncology Practice

Xavier Leleu, MD, PhD, head of the department of hematology and myeloma clinic at Hôpital La Mileterie in Poitiers, France, continued his conversation with Pharmacy Times® at the 22nd annual International Myeloma Society (IMS) meeting and exposition in Toronto, Canada, discussing how on-body injector (OBI) technology can ease clinical workflows by reducing preparation time for pharmacists and saving nurses from time-intensive manual pushes. He noted that OBI’s fully automated design also empowers patients to complete treatment safely and efficiently, with minimal local reactions reported in clinical trials. Overall, Leleu emphasized that this approach improves satisfaction across the care team and supports broader use of Sarclisa-based regimens in diverse patient populations.

Pharmacy Times: From a pharmacist’s perspective, what practical considerations should be kept in mind when integrating an OBI into clinical workflows?

Xavier Leleu, MD, PhD: The way the patient appreciated the OBI was in terms of quality of life and activity, which was very important. It was really great. Now, what is important is that it’s not only the physician that treats the patient—it’s a team. You need the pharmacist. They get the product, deliver the product, and in the case of daratumumab, for example, they have to reconstruct the product. So, it’s a lot of pharmacist time. Given the number of myeloma patients we have and who are going to receive isatuximab, it’s a very significant amount of time that pharmacists spend preparing isatuximab IV or daratumumab subcutaneous manual push.

Point number 1: the pharmacist.
Point number 2: the nurse.

Nurses see dozens of patients in the outpatient clinic every day. In my department, they treat 12 patients at the same time. While they are pushing subcutaneous daratumumab manually to one patient for five minutes, they are stuck with that patient. They cannot stop in the middle and move on to another of the remaining 11 patients. They must finish with one patient and then move on to the next, repeating the same process.

From my experience, OBI technology is totally automated. This means that the first time the patient uses it, the nurse or physician will educate them, but after that, I truly think the patient could do it on their own. I know that in many countries, regulations may not allow patients to do it themselves without a nurse, but honestly, they could. The OBI is completely automated: you stick it to your skin, push the button, take the ribbon out, and it works. The needle comes out, the injection is given, and you see the product passing through in a small window. When it’s done, you feel the needle retract, you know it’s complete, and then you remove it and move on. There is really no need for a nurse to do that.

For pharmacists, with the OBI and vial plugged in, it is going to be simple and time-saving. For nurses, it will save a tremendous amount of time. You give it to the patient, and the patient can do it themselves. As a physician, when I see my pharmacists happy, my nurses happy, and my patients happy, it makes my life easier. I believe OBI will make a tremendous difference for the entire team—not just for the patients or physicians.

Pharmacy Times: Looking ahead, how can pharmacists support both the implementation of novel delivery methods like OBI and the optimization of Sarclisa-based regimens in diverse patient populations?

Leleu: This is very important. A couple of comments here.

Number one: pharmacists will very quickly appreciate how OBI technology saves time. From what I’ve heard—and it still needs to be verified—when isatuximab OBI is commercialized, the pharmacist and patient will receive the OBI with the vial already together. So, you won’t have to store millions of OBI boxes in one place and isatuximab vials in another. It will come as a combined product. This makes it very easy for pharmacists. There will be a simple way of containing and delivering it, with no reconstitution required. The destruction of the product will also be easy. For pharmacists, it will be ultra-quick and ultra-simple compared with isatuximab IV or daratumumab subcutaneous manual push.

Number two: patients in clinical trials are not always representative of real life. In real life, you have elderly patients, patients with different education levels, and patients with obesity or diabetes. You must be careful when injecting these patients because of the risk of local reactions or infections. What we know from the HERACLES study and with isatuximab subcutaneous is that local reactions were extremely minimal. With daratumumab, the rate of local reactions is about 7% in publications. With isatuximab OBI, the rate was only 1.5%, and all were grade 1.

For patients, this makes an enormous difference, especially for those at risk when receiving injections. In the HERACLES study, 97% of patients completed treatment within 20 minutes, with a median time of 12 minutes. That’s very quick. One hundred percent of patients were injected successfully, and none of the devices failed.

Globally, for patients and the care team, the most important thing is that the patient receives the treatment, is happy receiving it, and will come back for the next dose. It is safe for patients because the device works, the drug is administered effectively, and it treats myeloma. We had 100% success in HERACLES, which speaks to the great progress being made for patients.