In recognition of Cancer Immunotherapy Month, the Association of Community Cancer Centers’ (ACCC) Immuno-Oncology Institute recently released “Immuno-Oncology in 2020: What We’ve Learned and What Lies Ahead,” an overview of the current state of immuno-oncology.
In the time since the FDA first approved ipilimumab for the treatment of patients with unresectable or metastatic melanoma, immunotherapies have gained approval for the treatment of more than 20 cancer subtypes, and have been widely adopted by academic and community clinicians. There are currently more than 500 ongoing phase 2 clinical trials of cancer immunotherapies across a variety of disease states.
“I think the huge learning curve that immuno-oncology presented has significantly flattened out just by virtue of the explosive availability of immuno-oncology therapies in the community, and the sheer necessity for physicians to learn to work with this particular class of drug,” said Sigrun Hallmeyer, MD, chair of the ACCC Immuno-Oncology Institute Executive Committee, in a press release. “In many cases, it has become the standard of care, and if you want to practice oncology today, you have to understand it.”
The current publication addresses the expansion of immuno-oncology within community practice, as well as the issues community oncologists should expect over the coming decade. These include the growing use of immunotherapies as neoadjuvant and adjuvant cancer treatments; the increase of immunotherapies in combination or sequential treatments with other agents; and the expectation of further availability in the community space.
The report also focuses on the long-term needs of patients treated with immunotherapies. “The number of patients with cancer who are eligible to receive immuno-oncology has increased since the approval of ipilimumab in 2011, as has the percentage of patients who are estimated to respond to treatment,” the authors wrote. “The magnitude of this response raises new challenges for patients and providers, including how to manage the transition into survivorship.”
Survivorship issues that require further research and planning include delayed or unexpected immune-related adverse events, reliable follow-up, access to psychosocial care, and systems to assuage the financial burden associated with immunotherapies.
Strategies outlined in the report include an online directory that will aid clinicians in identifying potential immune-related adverse events; virtual toxicity teams, which bring together oncologists and non-oncology specialists to identify potential adverse events in real time; and webinars detailing emerging patient-reported outcomes.
“Immuno-oncology and survivorship have become practically synonymous, as immuno-oncology is delivering on the promise of helping cancer patients live longer,” said Hallmeyer. “This means our focus must include delivering resources to the whole care team delivering survivorship care. It’s a welcome set of new challenges.”
Looking ahead, the report identifies telemedicine, virtual patient navigation, multispecialty care coordination, and the translation of big data research into clinical practice as areas in need of further focus and investigation.