549P Assessing the efficacy of cognitive behavioral therapy on anxiety, depression, and distress in people with lung cancer

Background: Home-based administration of cancer immunotherapy (IO) is an emerging care model aimed at improving patient-centered care and accessibility.However, real-world evidence regarding its feasibility, safety, and patient experience remains limited. Methods:In May 2025, a pilot program for home-based IO delivery was launched through a multidisciplinary collaboration between the Medical Oncology, Hospital at Home (HaH), Pharmacy, and Occupational Health services at the University Hospital of Cruces in Bizkaia (Spain).Patients with non-small cell lung cancer (NSCLC) receiving IO monotherapy who had previously tolerated treatment in the Day Hospital without complications and were expected to receive at least three additional cycles were included.Clinical characteristics, treatment exposure, safety, feasibility, quality of life (EORTC QLQ-LC13), and patient satisfaction (SATISFAD-10 questionnaire) were prospectively collected.Results: 22 patients were included (mean age 65 years, range 50-79; 50% female) from May to December 2025.Adenocarcinoma was the most frequent histology (45.5%).TNM stages included IVB (50%), IVA (13.6%),IIIC (4.5%), IIIB (13.6%),IIIA (9.1%), and II (9%).Pembrolizumab was administered in 81.8% of patients and atezolizumab in 18.2%, with intravenous administration in 81.8% and subcutaneous in 18.2%.Treatment intent was palliative in 90.9% of cases and adjuvant in 9.1%.Patients had received a mean of 10.4 prior hospital-based IO cycles (range 1-33) and a mean of 5.4 cycles administered at home (range 1-11).Adherence was good, all prescribed cycles were administered, with no infusion reactions or acute treatment-related adverse events.No clinically relevant deterioration in EORTC QLQ-LC13 scores was observed after initiation of home-based treatment.Patient satisfaction assessed by SATISFAD-10 was very high, and 95.5% of patients chose to continue within the home-based program. Conclusions:Home-based IO delivery coordinated by a HaH team in collaboration with Medical Oncology and Pharmacy services was feasible and safe, with high patient satisfaction and no negative impact on quality of life.This model represents a promising strategy to enhance patient-centered cancer care.