Key takeaways

  • Subcutaneous immunotherapy injections and IV infusions have similar efficacy and safety profiles for treating renal cell carcinoma.
  • Patients may find subcutaneous injections more comfortable and convenient due to reduced pain, shorter treatment times, and the option to receive treatment at a regular clinic instead of an infusion center.
  • When deciding between subcutaneous and IV therapies for renal cell carcinoma, patients should consider their personal preferences, lifestyle, and discuss the most suitable option with their doctor.

Doctors can combine immunotherapy with other treatments across various stages of renal cell carcinoma (RCC). Some types of immunotherapies involve the manipulation of immune checkpoint proteins. These proteins help the immune system recognize the tissues of the body as “self,” and they interact to prevent a person’s immune system from attacking the body’s own cells.

Many tumor cells express high levels of immune checkpoint proteins, which allows them to avoid detection by immune cells. Immune checkpoint inhibitor immunotherapy involves the use of an antibody to bind and block these proteins, allowing the immune system to recognize and attack RCC tumor cells.

Immune checkpoint inhibitor administration typically involves IV infusion through a vein. Options include:

  • atezolizumab (Tecentriq)
  • avelumab (Bavencio)
  • ipilimumab (Yervoy)
  • nivolumab (Opdivo)
  • pembrolizumab (Keytruda)

However, in December 2024, the Food and Drug Administration (FDA) approved a new version of nivolumab (Opdivo Qvantig) for use as a subcutaneous injection. This means a person can receive the drug as an injection under the skin.

This article discusses the differences and similarities between nivolumab subcutaneous injections and IV infusions for RCC to help people make the most suitable decisions for their treatment.

A 2025 clinical trial evaluated the efficacy of subcutaneous vs. IV nivolumab involving nearly 500 people with advanced or metastatic RCC. Half of the participants received subcutaneous nivolumab, and the other half received IV nivolumab.

After 6 months, investigators found that similar numbers of participants had partial or complete shrinkage of their tumors, regardless of how they received nivolumab therapy. In the subcutaneous treatment arm, 24.2% of people experienced a treatment response compared with 18.2% in the IV arm (the difference between the groups was not statistically significant). Higher response rates were seen in both groups with longer follow-ups.

Additionally, progression-free survival, a measure of the length of time before the cancer progresses, was also similar between groups. This suggests the sustained efficacy of subcutaneous nivolumab is similar to that of IV nivolumab.

Due to the nature of treatment with immune checkpoint inhibitor-based therapies, which involves manipulating the immune system, some immune-related side effects can occur, such as:

  • skin rashes
  • pruritus (itching)
  • diarrhea
  • hypothyroidism (fatigue, dry skin, dysregulated metabolism)

In the clinical trial of IV vs. subcutaneous nivolumab, both treatment groups experienced similar adverse events. The frequency of adverse events was lower with subcutaneous vs. IV treatment, but more people in the subcutaneous treatment group had at least 1 dose delayed due to a treatment side effect or other safety reasons.

Reactions at the injection or infusion site are common with either treatment. These are temporary side effects but may cause:

  • redness or discoloration
  • swelling
  • pain

In surveys of people who had received both subcutaneous and IV nivolumab, more individuals preferred subcutaneous administration to IV. Subcutaneous injections offer various benefits over IV infusions that may help improve the comfort and convenience of RCC treatment.

For instance, a person typically receives IV immunotherapy infusions every 2 or 4 weeks over the course of up to 2 years. Due to the frequency of IV treatments, a surgically implanted port often helps administer the drug easier, since locating a vein each time can be painful and time consuming. Discomfort can arise during installation and long-term maintenance of the port, whereas subcutaneous injections involve a single injection with significantly less long-term pain or discomfort.

Although IV ports reduce the time required to administer treatment, infusions still take up to 30 minutes. Subcutaneous injectable drugs can be a much quicker process. However, some observation is still typically required after injections, and the actual difference in treatment time may not be all that notable.

Another consideration for people receiving treatment is that IV infusions must occur at an infusion center. Depending on the location of the infusion center and how busy it is, people may have to travel long distances or find it difficult to make an appointment.

In contrast, subcutaneous injections can occur at a regular clinic closer to home. This may appeal to people wanting to reduce the stress and inconvenience of treatment logistics while saving time and expenses on longer travel to an infusion center.

Notably, though, while subcutaneous injections are often preferable over IV injections, some people report they perceive IV infusions to be more effective than subcutaneous injections, making them feel more comfortable with IV treatment.

People with RCC have various treatment options, including the new subcutaneous injectable nivolumab. The efficacy and safety of subcutaneous nivolumab is similar to that of IV nivolumab, and many people may prefer the ease and convenience of subcutaneous vs. IV treatment.

However, cancer treatment is a personal decision, and people may want to consider their preferences when weighing their options. Some people may enjoy connecting with others while receiving IV treatment or prefer more face time with their healthcare team during infusions.

When evaluating treatment options, people with RCC should consider their lifestyle and personal preferences and discuss with a doctor which route of administration is most suitable.