The efficacy of IO has led to a growing population of patients living with and beyond cancer. This has challenged original concepts of survivorship care, starting with the very definition of “survivorship.”
Our busy community practice first began treating patients with immunotherapy through participating in the original ipilimumab clinical trials. We quickly realized that this new treatment paradigm would require us to create and implement an effective screening and management tool for our immunooncology (IO) patient population.
Patients with complex medical needs, such as those with active autoimmune conditions, hepatitis B or C, and those receiving corticosteroids at baseline, may now receive these agents in the community. This raises important questions regarding safety, monitoring, and the likelihood of an anticancer response in these patients.
Immune-related adverse events (irAEs) are a complex category of symptoms driven by anti-cancer immunotherapy treatments. The use of IO has burgeoned since the approval of ipilimumab in 2011 through multiple approvals of anti-PD-1/PD-L1 drugs and most recently CAR-T therapies, and so too has the number of recognized irAEs.
Survivorship care planning requires communication, care coordination, and education. Since immune-related adverse events are still being discovered, these discussions are even more imperative.