Guests/Speakers
Dr. Coral Olazagasti, Assistant Professor of Thoracic Oncology, Sylvester Comprehensive Cancer Center, University of Miami
Jeanne Szurek, Voices of Hope Speakers Bureau patient advocate living with lung cancer
Switching From IV to SubQ: What Patients Should Know
When your oncologist tells you that a medication you’ve been getting by IV now comes as a subcutaneous (SubQ) injection, the news can raise as many questions as it answers. Is it really the same treatment? Will it hurt? Can I switch partway through? Patient host Jeanne Szurek, who made the switch herself, takes a deeper dive into switching from IV to SubQ with Dr. Coral Olazagasti, assistant professor of thoracic oncology at Sylvester Comprehensive Cancer Center at the University of Miami.
Dr. Olazagasti covered the fundamentals with LCFA Speakers Bureau member Stephanie Williams in Sub-Q 101. This conversation picks up where that one left off, with the practical decisions patients face once SubQ is on the table.
New to SubQ? Start with the basics on the Subcutaneous Cancer Treatment page.
Is SubQ Really the Same Treatment?
It’s a question Dr. Olazagasti hears often in clinic. If an infusion that used to take hours now takes minutes, is something being lost? Her answer is that speed doesn’t tell you how well a drug works.
“The amount of time that it takes to give the drug or the medication doesn’t tell us how effective that medication is.” — Dr. Coral Olazagasti
Before a SubQ formulation is approved, she explains, researchers study how the body absorbs it, what drug levels patients reach, and whether it produces the intended effect. It’s the same drug, delivered a different way, and it has to clear the same bar for effectiveness before approval.
What a SubQ Injection Actually Feels Like
Jeanne asks the question many patients hesitate to raise: does it hurt? Dr. Olazagasti explains that SubQ skips the port, PICC line, or IV entirely. A small needle goes into the fatty tissue of the arm, abdomen, or thigh, usually over just a few minutes. She won’t promise that patients will feel nothing. Some feel pressure, burning, or stinging, and some have soreness, redness, or swelling at the injection site afterward. For most people, these effects are manageable.
She is just as clear that SubQ is a choice, not a requirement.
“The fact that you qualify for a subcutaneous medication doesn’t mean that you’re forced to do it. Absolutely not. It just means that you have more options in your repertoire.” — Dr. Coral Olazagasti
Heading to an appointment soon? Download LCFA’s free SubQ Conversation Toolkit.
Side Effects: What Changes and What Doesn’t
Dr. Olazagasti sorts side effects into two groups. Systemic side effects come from the drug itself, so they generally stay similar whether it goes in by IV or SubQ. Administration-related side effects, such as infusion reactions, are where SubQ may help.
For Jeanne, that difference was personal.
“I had a reaction with nearly every infusion, and I ended up getting a reduced dose every time.” — Jeanne Szurek
When she read that the SubQ version was showing milder and fewer side effects and reactions than the IV form, she was ready to try it. For patients already doing well on IV, Dr. Olazagasti adds, switching shouldn’t bring surprises. It’s the same drug, and the body shouldn’t react any differently.
Want a patient-to-patient perspective? James Hiter and Stephanie Williams talk candidly about weighing IV vs. subcutaneous cancer treatment.
Switching From IV to SubQ Mid-Treatment: Who’s Eligible?
Not every lung cancer treatment has a SubQ version. Whether it’s an option depends on the medication, whether that formulation is approved, and your individual treatment plan. In general, patients can switch in the middle of treatment.
Staying on IV is a valid choice, and switching back from SubQ is possible if it isn’t working for you.
When Insurance Says No
Coverage is part of the conversation, but it may be less of an obstacle than patients expect. At her practice, Dr. Olazagasti says, “for 90% of the patients, the insurance doesn’t give us any pushback.”
When coverage is denied, that isn’t the end of the road. Her team appeals the decision or requests a peer-to-peer review, where the prescribing oncologist speaks directly with the insurer’s medical reviewer. Patients don’t have to navigate that alone, and asking your care team what happens next after a denial is a fair and useful question.
Wondering if SubQ is an option for you? Bring LCFA’s list of questions to your next visit.
The Real Time Savings
Jeanne notes that treatment day is more than the injection itself. There’s parking, check-in, blood work, seeing the doctor, and waiting on the pharmacy. SubQ doesn’t remove those steps. What it shortens is administration time: a 90- to 120-minute infusion can become a three- to six-minute injection.
Jeanne’s savings started days before treatment. On IV, the pre-medication steroids cost her sleep and then a crash; she describes it as “kind of a lost week.” With SubQ, she needed a steroid only for the first injection. On days when the injection is all she’s getting, she’s usually out of the clinic in about 90 minutes, compared with up to four hours for a full IV appointment. She spends that time volunteering and advocating in her community.
“You get time back, and that’s very important.” — Dr. Coral Olazagasti
A Shift in Mindset
For Jeanne, the change went beyond the clock.
“My whole attitude toward treatment days started to change as soon as I got that first subcu injection.” — Jeanne Szurek
Dr. Olazagasti says that is the point. Patients are living longer, and “we don’t want their lives to revolve around treatment days.” The goal is to lighten the emotional, time, and toxicity burden on patients and caregivers.
Questions to Bring to Your Oncologist
Dr. Olazagasti keeps it simple:
“Is there a subcutaneous version of the treatment that I’m receiving? And if there is, can I get it?” — Dr. Coral Olazagasti
If the answer is no, ask whether a SubQ option might exist for a future treatment. Oncologists usually have a plan A, B, and C, and knowing your preferences helps them plan ahead.
Where SubQ Is Heading
Speaking from the 2026 World Conference on Lung Cancer in South Korea, Dr. Olazagasti noted that new studies are evaluating SubQ formulations. She expects SubQ options to keep growing, driven by research that increasingly centers the patient experience.
“Patients are just much more than just survival curves.” — Dr. Coral Olazagasti
Catch the conversation that started it all. Stephanie Williams and Dr. Olazagasti cover the fundamentals in What Is SubQ? How Subcutaneous Treatment Is Changing Life With Lung Cancer.
Content shared in this episode reflects personal experiences and should not substitute for professional medical guidance. Please consult your healthcare provider for personalized medical advice.
