Management of Hospital Admissions for Checkpoint Inhibitor Immune-Related Adverse Events at a Regional Cancer Center

In Brief

The use of immune checkpoint inhibitors in oncology has surged over the past decade and is projected to continue increasing for years to come. With the forecasted rise of immunotherapy use, it is now more important than ever to ensure the safety of patients who are receiving these agents. The toxicity profiles of immunotherapy agents are vastly different from traditional cytotoxic chemotherapies. Immune-related adverse events (irAEs) can lead to life-threatening outcomes if not treated appropriately. Incidence of severe irAEs (grade 3 or 4, which may require hospitalization) varies across publications, and minimal data are available to indicate what percentage of hospital admissions of immunotherapy-treated patients are due to irAEs. Determining this figure may clarify the actual hospitalization burden of irAEs on hospital systems. In addition, evaluating health systems’ clinical management of irAEs can uncover areas of improvement in quality of care for immunotherapy treated patients. In June 2018, the National Comprehensive Cancer Network (NCCN) and American Society of Clinical Oncology (ASCO) released guidelines on the management of irAEs. St. Luke's Health System used these guidelines to evaluate where the health system consistently met these benchmarks and identify areas of improvement.

Acknowledgments

Thank you to Dr. Robert Mancini, Dave Wilson, Dr. Dan Zuckerman, and Amanda Dixon for their guidance and contributions to this project.

Additional information

Notes on contributors

Andrew Li

Andrew Li, PharmD, is a clinical oncology pharmacist and Michela Altergott, PharmD, is a lead clinical oncology pharmacist at St. Luke's Cancer institute in Boise, Idaho.

Michela Altergott

Andrew Li, PharmD, is a clinical oncology pharmacist and Michela Altergott, PharmD, is a lead clinical oncology pharmacist at St. Luke's Cancer institute in Boise, Idaho.