Implementation of an outpatient multidisciplinary model for care of immune-related adverse events.

Abstract

e13608 Background: In recognition of the growing burden of acute and chronic immune-related adverse events (irAEs) experienced by patients (pts) treated with immune checkpoint inhibitors and the need for multidisciplinary expertise, the Cancer Immunotherapy Toxicity Evaluation Program (CITE-P) was created at UCSF. Here, we evaluate the impact of CITE-P since its launch in April 2023. Methods: CITE-P is a medical oncologist-directed and nurse practitioner-led clinic within the UCSF Helen Diller Family Comprehensive Cancer Center. Pts with any irAE can be referred; pts may also self-refer. Expedited in-person and telehealth visits are offered with CITE-P providers, with expedited subspecialty consultation available by referral. Multidisciplinary care is facilitated through biweekly virtual meetings. Retrospective review of patients seen for irAEs at CITE-P was performed. Referral data were collected using the UCSF electronic medical record. Results: Between April 2023 and Dec 2025, 454 new pts were seen by CITE-P, of which 259 (57%) were women, and 194 (43%) were men. 110 (18%) pts were referred from external community or affiliate sites. The most common malignancies represented among referred pts were melanoma/skin cancers (21%), lung cancer (18%), breast cancer (11%), genitourinary cancers (11%), and GI cancers (11%). The most common reasons for referral were for endocrine irAEs (24%), GI irAEs (colitis/diarrhea, 22%), rheumatologic irAEs (14%), and hepatic irAEs (14%). Longitudinal care was important, with this new pt population generating 1531 subsequent follow up visits at UCSF. UCSF Cancer Center new pt metrics were met or exceeded for fiscal year 2025 (FY25), with 100% new pts seen within 14 calendar days from referral (goal 85%), 75% new pts seen within 7 calendar days (goal 75%), and 85% new pts seen within 5 calendar days (goal 85%). Conclusions: CITE-P creates infrastructure for pts diagnosed with acute and chronic irAEs both at UCSF and within our catchment area access to expedited specialty care. This novel multidisciplinary outpatient program facilitates timely multidisciplinary care coordination for pts with irAEs.