Abstract 3457
Background
With immunotherapy (IO) being the standard of care in melanoma, over time this has led to pressures within the medical day unit (MDU), especially as other cancer algorithms have evolved incorporating IO. Main pressures include reduced capacity, increasing patient numbers leading to greater pressure on doctors and requiring greater consultation time with patients to discuss survivorship issues. To help address these issues a pharmacist and nurse (P/N) led clinic was created as a new model of care in 2017.
Methods
Melanoma patients prescribed IO are placed into the clinic and reviewed 2-4 weekly as per IO regimen. Doctors review patients 12 weekly in outpatients for scan results. To assess the benefit of the clinic the number of referrals made back to the doctor before 12 weeks were recorded. Consultations needing >10 mins to discuss survivorships issues and P/N interventions were recorded.
Results
36 patients (age 24-89 yrs) have been referred to the clinic; 33 needed IO treatment, 2 steroid weaning and 1 temozolomide patient, needing nursing support. All patients required clinical evaluation for consideration of next cycle. Doctor’s input was required for 4 patients; 2 for inpatient admission for IO toxicity (monitoring for adrenal insufficiency, diabetic ketoacidosis), 1 for a biopsy (new skin nodule), 1 (scan results). Interventions routinely made by P/N included referrals to surgeons (3), dermatologist (2), ophthalmologist (2), tissue viability nurse (2), lymphedema team (2), physiological support (2) and fitness instructor (2). All patients required survivorship support and consultations ranged from 15-45 min. Common themes which emerged included how to partake in physical activity, anxiety on stopping IO, financial burden and advice on complementary therapies. In the melanoma team patients stop IO at 2yrs. Discussion on stopping IO is explored within 3 months of stopping IO; this discussion has occurred in 18/33 patients, in which the P/N helped alleviate patient’s anxiety over this time.
Conclusions
The clinic has become embedded within the melanoma service and has helped improve MDU pressures by removing patients requiring greater holistic support. This clinic in turn has sought out survivorship issues important to melanoma patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2655 - The K-BASKET trial: A prospective phase II biomarker-driven multiple basket trial in Korean solid cancer patients.
Presenter: Seul Kim
Session: Poster Display session 3
Resources:
Abstract
5938 - Cambridge Liquid biopsy “CALIBRATION” study: Can changes in circulating tumour DNA (ctDNA) predict durable tumour responses in patients with advanced oesophageal cancer receiving MEDI4736?
Presenter: Constanza Linossi
Session: Poster Display session 3
Resources:
Abstract
3799 - Validation of a tumour mutational burden workflow on routine histological samples of colorectal cancer and assessment of a cohort with synchronous hepatic metastases
Presenter: Andrea Mafficini
Session: Poster Display session 3
Resources:
Abstract
4647 - Microsatellite Instability Testing and Lynch Syndrome Screening For Colorectal Cancer Patients Through Tumor Sequencing
Presenter: Li Liu
Session: Poster Display session 3
Resources:
Abstract
3231 - "Liquid Withdarw" technique in CT-guided cutting needle lung biopsy: decreased incidence of complications and increased tissue amount for lung cancer molecular testing.
Presenter: Xue Wang
Session: Poster Display session 3
Resources:
Abstract
3282 - WGS Implementation in standard cancer Diagnostics for Every cancer patient (WIDE)
Presenter: Paul Roepman
Session: Poster Display session 3
Resources:
Abstract
5905 - Known and unknown gene fusion detection capabilities of solid tumor laboratories conducting next generation sequencing in 6 countries
Presenter: Steph Finucane
Session: Poster Display session 3
Resources:
Abstract
4238 - Clinical and Analytical Accuracy of a 523 Gene Panel Next-Generation Sequencing (NGS) Assay on Formalin-Fixed Paraffin-Embedded (FFPE) Solid Tumor Samples
Presenter: Ina Deras
Session: Poster Display session 3
Resources:
Abstract
2493 - Methylation analysis of MLH1 using droplet digital PCR and methylation sensitive restriction enzyme.
Presenter: Celine De Rop
Session: Poster Display session 3
Resources:
Abstract
2963 - Analytical performance of the Resolution-HRD plasma assay used to identify mCRPC patients with biallelic disruption of DNA repair genes for treatment with niraparib
Presenter: Ira Pekker
Session: Poster Display session 3
Resources:
Abstract