Abstract 1864P
Background
Immune checkpoint inhibitors (ICIs) are now a major part of everyday practice in cancer care, responsible for frequent and potentially severe immuno-related adverse events (irAEs). In this nationwide multicenter descriptive study, we report the organization of irAEs management networks within the regional reference centers in France.
Methods
All university hospitals (UH, n=30) with medical oncology departments and comprehensive cancer centers (CCC, n=18) in metropolitan France were included. Data were collected through an online standardized questionnaire sent by e-mail to all of these centers.
Results
From September 2020 to February 2021, 48 institutions were contacted, of which 41 filled the survey (response rate 85%) including 24 UH (59%) and 17 CCC (41%). Sixteen centers (39%) had implemented a multidisciplinary tumor board (MTB) dedicated to irAEs management and 25 (61%) a network of specialists. The additional resources available included therapeutic patient education consultations at 16 centers (39%), internal medicine consultations at 10 (24%), and referral internal medicine board at 7 (17%). The main topics discussed at this MTB were diagnostic or therapeutic management of irAEs and rechallenge of ICI after irAEs occurrence in 100% of the cases. Introduction of ICI was also discussed in 68% and the resuscitation status of the patient was recorded in only 19% of them. The presentation of every irAEs was systematic in only 19% of the cases. Limitations in implementing these MTB and networks were time issue (63% of respondents), difficulty to bring together physicians at the same place (41%), lack of a digital platform or funding (27%), redundancy with classical MTB (17%), lack of premises (7%), and limited number of patients (7%).
Conclusions
IrAEs management are heterogenous in France, based on the multidisciplinary collaboration of several physicians organized as a dedicated tumor board or as a physician network within UH and CCC. The main challenges for regional reference centers are facilitating access to medicine subspecialists expert in the field of irAEs management and sharing the knowledge acquired for the benefit of the greatest numbers.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Centre Oscar Lambret.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.