Category: Federal Forum Posters
Purpose: Immunotherapy has revolutionized oncology practice by showing improved overall survival in various malignancies. However, their unique mechanism of action can lead to immune-related adverse events (irAEs), which can occur in any organ and be life-threatening. At the San Francisco Veterans Affairs Health Care System (SFVAHCS), the veteran population tends to be older with multiple comorbidities and have poorer overall performance status that may influence the rate of irAEs. The goal of this quality improvement project is to evaluate the incidence and severity of irAEs in veteran cancer patients treated with immunotherapy at the SFVAHCS.
Methods: This is a retrospective chart review of patients who have received at least one dose of immunotherapy (ipilimumab, nivolumab, pembrolizumab, atezolizumab) from the SFVAHCS Oncology Service from June 1, 2011 to June 30, 2018. Patient charts will be reviewed to see if the patient experienced an irAE during treatment and up to 3 months after the last dose. Any patients co-managed by a non-Veterans Affairs oncologist and/or patients receiving both immunotherapy and chemotherapy simultaneously will be excluded. The following data will be collected: patient age, gender, baseline weight, baseline serum creatinine, baseline hepatic function, baseline thyroid function, autoimmune-related comorbidities, relevant active medication, cancer diagnosis, cancer stage, initial performance status using the Eastern Cooperative Oncology Group score, prior oncologic therapy, programmed death-ligand 1 status, immunotherapy start date, immunotherapy dose, and total number of immunotherapy doses received. If an irAE occurred, the following data will be collected: irAE type, relevant laboratory results, irAE grade using the Common Terminology Criteria for Adverse Events version 5.0, date of first irAE, treatment of irAE, treatment delays and/or discontinuations of immunotherapy due to irAE, and emergency room visits or hospitalizations related to irAE. Data will be analyzed using descriptive statistics.
Results: not applicable
Conclusion: not applicable
Sophia Ma– PGY1 Pharmacy Resident, San Francisco Veterans Affairs Health Care System, San Jose, CA