Combination Products in Oncology Therapeutics

Abstract

Oncology combination products -- drug-device or biologic-device combinations designed to deliver cytotoxic, targeted, or immunotherapeutic agents with device-enhanced precision -- represent a rapidly growing therapeutic category addressing limitations of systemic chemotherapy and standalone biologic administration. From antibody-drug conjugates delivered through implantable port systems to radiation-sensitising nanoparticles activated by brachytherapy devices and checkpoint inhibitors administered via on-body injectors, the integration of oncology drugs with delivery devices creates synergistic therapeutic platforms with superior localised drug concentrations, reduced systemic toxicity, and improved patient adherence. This study presents the Oncology Combination Product Assessment Framework (OCPAF), evaluating five combination product strategies -- systemic biologic plus on-body injector, locoregional chemotherapy plus implantable pump, radiosensitiser plus brachytherapy device, immunotherapy plus drug-releasing scaffold, and theranostic nanoparticle plus imaging-guided activation device -- across four oncology indications: solid tumour chemotherapy, intracranial malignancy, haematological cancer, and post-surgical recurrence prevention. Our Oncology Combination Product Score (OCPS) integrates tumour drug concentration enhancement, systemic toxicity reduction, treatment adherence improvement, regulatory pathway clarity, and clinical evidence maturity. Locoregional chemotherapy via implantable pump achieved the highest OCPS (0.926) through direct intratumoural or regional arterial drug delivery that achieved 12-fold higher tumour concentrations than systemic administration while reducing systemic exposure by 86%, while theranostic nanoparticle platforms achieved the highest spatial precision (0.952) through real-time imaging confirmation of tumour accumulation before device-triggered drug release.