Trends in immune-related adverse event reporting among multidisciplinary cancer programs.

Abstract

e14529 Background: The Association of Cancer Care Centers’ (ACCC) Immuno-Oncology (IO) Institute provides foundational IO education to multidisciplinary care teams and conducts a periodic census survey to understand evolving trends and needs of its members. Immune-related adverse events (irAEs) associated with treatment of cancer have variable clinical presentations and outcomes. This complexity, coupled with growing use of novel immunotherapies, poses challenges in practice, particularly in outpatient oncology settings. There is currently a lack of guidelines for management of irAEs in this environment. Methods: Guided by the IO Institute’s advisory committee, the census survey was developed based on literature reviews and validated instruments from prior surveys. Survey logic limited testing and treatment questions to providers. The survey was administered from August 1- November 4, 2024. Descriptive analyses were completed in R (version 4.4.1) and SAS Studio 3.8 on SAS 9.4. Results: Sixty-nine unique responses represented diverse program settings in urban, rural, and suburban areas. Physicians reported most confidence in applications of ICIs (82%), and combination therapies (73%). They reported the least confidence in applications of chimeric antigen receptor (CAR) T-cell (33%) therapy, tumor infiltrating lymphocytes (TIL) (33%) therapies, and cancer vaccines (24%). Toxicity discussions with patients were a frequent component of patient encounters. 77% of respondents indicated their institutions offered irAE-specific training. The top indicated institutional priorities regarding IO were staying informed of immunotherapy advancements and new treatment options (57%) and multidisciplinary collaboration (51%). Respondents identified multiple mechanisms for irAE reporting (Table 1). Conclusions: Despite widespread institutional training availability, inconsistencies in irAE reporting exist. Variability in confidence levels across therapy types coupled with institutional priorities highlight the need for irAE monitoring and management guidelines in the outpatient setting. Improved coordination with primary care and other specialties are critical to ensuring timely intervention for irAEs in diverse clinical settings. Reporting Mechanism Frequency (n) Myself, or a team member, follows up with patients as part of standard protocol 50 Patient's self-report (ie, patient portal, phone call, etc) 37 I rely on another treating provider to notify me 15 I rely on the patient's primary care physician to notify me 11 Not applicable to my role 10 Other (please specify): 2 N=125; multiple responses allowed