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Immuno-Oncology Insights Series

Authored by members of the ACCC IO Institute Working Groups, the Immuno-Oncology Insights series brings forward perspectives and real-world strategies for tackling current challenges in delivery of immunotherapy for cancer, as well as thought-provoking, potential next steps for optimizing care in this rapidly growing field. Reader response is encouraged.

Big Data Working Group

  • Predictive Modeling: What, Why, How
    By Ivo Abraham, PhD, RN

    Envision a day that cancer clinicians can ask an app to advise on immuno-oncology (IO) treatment options for a patient. That day may not be far off. Big data, deep analytics, and predictive modeling methods are transforming how cancer clinicians weigh treatment options.

  • Predictive Modeling to Inform IO Regimen Choice
    By Ari VanderWalde, MD, MPH, MBioeth

    Immune-related adverse events (irAEs) are extremely common in patients being treated with checkpoint inhibitors for advanced melanoma. The type, quality, and severity of these adverse events, however, varies by treatment regimen and by patient.

  • Big Data, Deep Analytics, Better Outcomes
    By Ivo Abraham, PhD, RN
    The promises of Big Data are intuitively appealing: (virtually) unlimited data that will enable us to answer (virtually) any questions that we may have. Unfortunately, by and of themselves, Big Data are rather useless. They require Deep Analytics: inquiring people equipped with engines of analysis to explore, discover, and invent.
  • Powering Personalized Immuno-Oncology: Big Data’s Role
    By Nikesh Kotecha, PhD
    Determining the best personalized treatment for a patient will require input from a team of physicians, ideally with access to a patient’s information over time and across multiple modalities. Collecting data in a consistent, secure, and scalable manner with the ability to share across disciplines will be vital to furthering personalized medicine. 
  • Harnessing Real-Time, Real-World Data to Improve Care
    By Matthew R. Zibelman, MD

    As a genitourinary medical oncologist specializing in immunotherapy for kidney and bladder cancers, I am continually striving for more ways to connect with and learn from my patients. The emerging availability of immuno-oncology (IO) drugs for the conditions I treat, as well as many other cancer types, has generated tremendous excitement amongst patients and oncologists, but there still is so much we don’t know.

Multispecialty Coordination and Communication Working Group

  • Survivorship Care in the Era of Immuno-Oncology
    By Sigrun Hallmeyer, MD

    The positive impacts of IO therapy are remarkable, the era of IO has also ushered in new challenges. 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.”

  • Managing IO Toxicities: Three Keys to Success
    By Sigrun Hallmeyer, MD

    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. 

  • Checkpoint Inhibitors for Those with Complex Medical Needs
    By Jarushka Naidoo, MB BCH

    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. 

  • Managing irAEs into Post-Treatment Survivorship
    By Brianna Hoffner, MSN, ANP-BC, AOCNP

    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.

  • Managing Survivorship Care After Immunotherapy
    By Regina Jacob, MD, MSCE

    Survivorship care planning requires communication, care coordination, and education. Since immune-related adverse events are still being discovered, these discussions are even more imperative. 

Subspecialty Insights


  • Subspecialty Insights in Immuno-Oncology: A Closer Look at APPs
    By Sarah Sagorsky, MPAS, PA-C

    Advanced Practice Providers (APPs), such as nurse practitioners and physician assistants, play a fundamental role within medical oncology departments and the care of patients with cancer.

  • Managing Dermatologic Adverse Events From Immunotherapy
    By Joshua Arbesman, MD

    Oncodermatology is a rapidly developing field that is attracting significant interest and generating new literature in the context of cancer treatment strategies.

  • Emergency Medicine Providers: Key Partners in the Acute Care of irAEs
    By Jason Bischof, MD

    The non-specific adverse events of immune-based therapies, which often mimic autoimmune disorders rather than traditional cytotoxic effects, pose a significant challenge to emergency medicine providers.

  • Working with Rheumatologists to Manage irAEs
    By Laura C. Capelli, MD, MHS

    Caring for patients experiencing toxicities from treatment with immune checkpoint inhibitors (ICIs) requires multidisciplinary input and coordination. Rheumatologists evaluate and treat patients experiencing a wide variety of immune-related adverse events (irAEs), including inflammatory arthritis, sicca syndrome, polymyalgia rheumatica, myositis, vasculitis, and scleroderma. It’s important for rheumatologists to know that these irAEs can vary significantly in their time of onset, severity, and treatment. Accurately diagnosing and treating rheumatic irAEs requires that providers obtain a tailored patient history and physical examination, since there are no definitive diagnostic laboratory tests for these complications. 

  • Transitioning to Primary Care After IO Treatment
    By Regina Jacob, MD, MSCE, FACP

    While immuno-oncology (IO) therapies have heralded significant advancements in cancer care, there are still many unknowns when it comes to the long-term side effects of these relatively new agents. Since ambulatory care typically involves long-term chronic disease management, these unknowns can often translate to management uncertainty.

Telemedicine Working Group

  • Cancer and Telemedicine
    By Rashid Bashshur, PhD

    When diagnosed with cancer, the typical patient responds with trepidation, anxiety, and fear. This experience engenders a bewildering set of questions, including the cause, treatment options, prognosis, appropriate sources of care, and affordability. Of paramount importance is ready access to expert resources with the requisite knowledge and skill. Telemedicine is a modality of care that addresses all these issues.

  • Virtual Navigation to Clinical Trials
    By Jennifer C. King, PhD

    In the current oncology clinical trials landscape, many barriers remain to clinical trial enrollment that affect both the oncologist and the patient. Among these are trial locations, strict eligibility requirements, insufficient resources to support appropriate clinical trial education and screening, as well as patient and provider attitudes about trials.

  • Telehealth: Partner in Innovation
    By Jennie R. Crews, MD, MMM, FACP
    The paradigm-changing advancements accompanying immunotherapy for cancer continue to require innovation in care delivery. Telehealth is a natural innovation partner for immuno-oncology when applied to patient-reported outcomes, provider education, and clinical trial enrollment. 

Training and Education Working Group

  • COVID-19 and Patients Receiving Anticancer Immunotherapy
    COVID-19 and Patients Receiving Anticancer Immunotherapy
    By Ryan M. Weight, DO, MS

    SARS-CoV-2 and the resulting respiratory tract infection COVID-19 has upended our society and forcefully changed the way we care for patients. Since the emergence of the virus in early 2020, there have been questions surrounding the risk posed to patients with a cancer diagnosis and the safety of anticancer therapies. 

  • Communication: Key to Addressing Toxicity and Recurrence Risks
    By Mark B. Faries, MD

    Immuno-oncology (IO) has radically altered the patient care paradigm. One of most important changes attributed to IO is improvement in outcomes and lengthening of survival. This good news comes with multiple challenges, not least of which is the need for new and better communication and coordination among multiple specialties over time. 

  • The Oncology Pharmacist's Role in IO Delivery
    By Sarah Hudson-DiSalle, PharmD, RPh

    Are you leveraging the assets of your oncology pharmacists in delivery of immunotherapy for cancer? Oncology pharmacists multidisciplinary team members who help bridge the gap between science and real-world medical practice. Sarah Hudson-DiSalle, PharmD, RPh, describes how your IO program can make the best use of the oncology pharmacist's diverse skillset.  

  • The Intestinal Microbiome and Cancer Immunotherapy
    By Ryan M. Weight, DO, MS

    The human gastrointestinal tract is inhabited by a diverse population of bacteria that play a crucial role in maintaining homeostasis both within the gut and within the body. How much do we know about the gut microbiome as it relates to cancer treatment?  

  • IO Reimbursement: Be Proactive and Prepared
    By Sarah Hudson-DiSalle, PharmD, RPh

    As with other high-cost treatments, integration of immunotherapies into practice requires a thorough understanding of payer policies and requirements for reimbursement. Sarah Hudson-DiSalle, PharmD, RPh, shares key steps for successful reimbursement for cancer immunotherapies.

  • Selecting Patients for Combination Immunotherapies
    By Ryan M. Weight, DO, MS

    A forthright conversation between the treating clinician, patient and family members on the importance of self-reporting adverse events must take place prior to consideration of combination immunotherapy.  

  • IO Trials Are Accruing: Where Are the Patients?
    By Joanne Riemer, RN, BSN

    Research nurse Joannne Riemer, RN, BSN,  started her position at Johns Hopkins Medical Institution in 2010. Within six months, she was working with checkpoint inhibitors. From her vantage point in clinical trials research, she discusses the many changes in IO clinical trials patient selection over the last eight years.