Abstract CN65
Background
Immune checkpoint inhibitors (ICI) and targeted therapy (TT) have improved the survival of people with metastatic melanoma (PwMM), with 50% achieving durable disease control. However, there are no models of survivorship care which address their physical and psychosocial concerns. MELCARE is a nurse-led survivorship program for PwMM who are long-term responders to ICI/ TT. It consists of two telehealth consultations three months apart, needs assessment using the NCCN Distress Thermometer (DT) and Problem List (PL), and creation of a survivorship care plan (SCP). We assessed its feasibility, acceptability and utility.
Methods
PwMM >18-years, >6 months post initiation of ICI with a complete response (CR) on computed tomography (CT) or >1 year post initiation of ICI with a complete metabolic response on positron emission technology scan and a CR/ partial response (PR) on CT or >2 years post initiation of TT with a CR on CT, able to have a telehealth consultation and complete online surveys were recruited from a single centre in Australia in October 2021.
Results
61 patients eligible, 54 (88%) contacted, 31 (57%) consented. Participants were male (21, 68%), median age 67 (range: 46-82), 11 (35%) receiving/ had received ipilimumab and nivolumab, 27 (87%) had ceased treatment. Results are shown in table. Feasibility was demonstrated with 97% completing MELCARE. The mean total nursing time per participant was 96 minutes (standard deviation, SD: 15). Utility was demonstrated on a customised survey and supported by a reduction in the mean DT score (initial: 5.6, SD: 2.9; follow-up: 1.5, SD: 1.2). Acceptability was demonstrated on 3/4 items on the Acceptability of Intervention Measure (AIM). The rate of consent was lower than expected. Table: CN65
| Endpoint | Result | |
| Feasibility | Rate of completion ≥ 70% | 30/31 (97%) |
| Rate of SCP production ≥70% | 30/30 (100%) | |
| Acceptability | Rate of consent ≥70% | 31/54 (57%) |
| ≥70% completely agree/agree with each item on the AIM measure | 1. MELCARE meets my approval: 25/29 (86%)2. MELCARE is appealing to me: 22/30 (73%)3. I like MELCARE: 25/30 (83%)4. I welcome MELCARE as part of my care: 20/30 (67%) | |
| Utility | ≥70% will: 1. State MELCARE improved their overall satisfaction with their melanoma care2. Rate both consultations as very helpful/ helpful3. Recommend MELCARE | 1. 22/28 (79%)2. Initial: 24/29 (83%); follow-up: 18/28 (64%)3. 28/28 (100%) |
| ≥70% will read and use their SCP | Read/use: 27/29 (93%) |
Conclusions
MELCARE is the first survivorship program for PwMM. MELCARE was feasible and acceptable with high levels of utility. Future studies should consider the optimal timing, resourcing and cost-effectiveness of MELCARE.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A.M. Menzies: Financial Interests, Personal, Advisory Board, advisory board: BMS, MSD, Novartis, Roche, Pierre Fabre, QBiotics. G.V. Long: Financial Interests, Personal, Other, Consultant Advisor: Agenus Inc, Amgen Inc, Array Biopharma Inc, Boehringer Ingelheim International GmbH, Bristol Myers Squibb, Evaxion Biotech A/S, Hexal AG (Sandoz Company), Merck Sharpe & Dohme (Australia) Pty Limited, Novartis Pharma AG, OncoSec Medical Australia, Pierre Fabre, Provectus Australia, Qbiotics Group Limited, Regeneron Pharmaceuticals Inc; Financial Interests, Personal, Advisory Board, Consultant Advisor: Highlight Therapeutics S.L. All other authors have declared no conflicts of interest.