CN64 - Three-year evaluation of an immunotherapy late effects screening clinic

Background

Early evidence suggests toxicities caused by checkpoint inhibitors may persist, be irreversible or have delayed onset (months after treatment completion) in 15-43% of patients. However, this early evidence is limited to clinical trials and case studies so real-world data is needed. We provide a 3-year update of our work aimed to characterise the ongoing effects of immunotherapy via an immunotherapy late effects screening service.

Methods

In our large regional cancer centre, an opt-in screening service for the late effects of immunotherapy was established in April 2021. Data collection has been included in the design of the service including: Patient self-identified needs using the Sheffield Profile for Assessment and Referral to Care Acute toxicity experienced during treatment Prevalence of persistent toxicity Prevalence of psychosocial needs Range and frequency of interventions required Patient experience of the service.

Results

In the first 3 years of the service 124 new patients were seen (103 melanoma, 8 renal, 6 bladder, 5 head & neck, 1 lung, 1GTD). On entry to the service over half of patients (67, 54%) reported ongoing side effects or symptoms following treatment completion with new, late toxicity being identified in 10 (8%) people. No further intervention was needed by 24% (30) patients. Most other patients only needed monitoring or supported self-care, but 17 (14%) required referrals to rehabilitation services, 7 (6%) to specialist medical teams for further investigations and management and 6 (5%) had new cancer symptoms so their oncology team were alerted. The most common concerns reported by patients were fatigue (43, 34%), skin reactions (26, 21%), arthralgia (25, 20%), sexual function (17, 14%) and anxiety (16, 13%). 73% of 52 patients who provided feedback on the service found it beneficial.

Conclusions

Toxicities not routinely recognised post-treatment and psychological impacts not always addressed. The late effects screening service facilitates identification and management and improves patient experience. A larger project has been planned to understand the prevalence of late effects following immunotherapy and to develop digital monitoring.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Sheffield Teaching Hospitals NHS Trust.

Funding

Yorkshire Cancer Research.

Disclosure

All authors have declared no conflicts of interest.