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. 2024 Jul;13(13):e7403.
doi: 10.1002/cam4.7403.

Multidisciplinary management of immunotherapy-related adverse events in solid tumors: An inter-institutional and telemedicine-based working team

Alessandro Iaculli  1 , Michele Ghidini  2 , Francesco Locati  3 , Laura Chiappa  4 , Giuseppe Nastasi  1 , Gianpiero Fasola  5 , Francesco Grossi  6 , Ornella Garrone  2 , Valeria D Tozzi  7
Affiliations

Multidisciplinary management of immunotherapy-related adverse events in solid tumors: An inter-institutional and telemedicine-based working team

Alessandro Iaculli et al. Cancer Med. 2024 Jul.

Abstract

Background: Although immune checkpoint inhibitors (ICIs) show a more favorable toxicity profile than classical cytotoxic drugs, their mechanism of action is responsible for peculiar new toxicities. There is an urgent need for a multidisciplinary approach to advice on how to manage organ-specific toxicities.

Methods: Our project aims to integrate the practices of two different hospitals into a single Italian regional collaborative model to treat immune-related adverse events (irAEs). The team structure is a multi-professional and multidisciplinary cooperative network that consists of different medical specialists. The team referrer is the medical oncologist and an existing telematic platform is used for specialists' cooperation. The leading oncologist first evaluates patients' clinical condition, therefore team intervention and teleconsultation are planned to activate proper management. After a first phase structured for general setting, outcomes analysis, data collection, and identification of critical issues, it is planned to define appropriate key performance indicators (KPIs) in quality, structure, process, and outcome settings. Therefore, a second phase would serve to implement KPIs. In the third phase, the proposal for the enlargement of the network with the extension to more centers in the context of the Regional Health Service will be performed.

Discussion: The multidisciplinary management of irAEs based on telemedicine fits into the debate on the renewal of healthcare systems and the push for change toward multidisciplinary with the rising use of telemedicine. To our knowledge, this is the first project reporting a multi-institutional experience for change of service in irAEs management.

Keywords: immune‐related adverse events; immunotherapy; key performance indicators; multidisciplinary team; teleconsultation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Operative checklist for suspected irAEs. ALP, alkaline phosphatase; CT scan, computed tomography scan; GGT, gamma‐glutamyl transferase; GOT/GPT, liver transaminases.
FIGURE 2
FIGURE 2
irAEs management flow‐chart. TSH, thyroid‐stimulating hormone.
See this image and copyright information in PMC

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