ACCC’s Precision Medicine Tools Help Guide Survivorship Care

Precision medicine is an emerging approach to disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle to make diagnoses and prognoses, tailor treatment plans, and assess the efficacy of treatment regimens for specific patients. As such, precision medicine avoids the pitfalls of more traditional one-size-fits-all approaches to treating disease, which  are developed for the “average” person without regard to individual differences.

Cancer has become the focus of some of the most promising precision medicine applications available today. The evolution of immunotherapy treatment for patients with cancer has given rise to a new class of cancer survivors whose novel experiences with these treatments require new tools and resources. In particular, managing potential toxicities during and beyond treatment requires coordinated care among multiple providers that is essential for positive outcomes.

However, instructive resources are not available to many of these patients, and current Commission on Cancer standards do not require cancer programs and practices to provide survivorship services to patients treated with immunotherapies. Nevertheless, access to such information can make the difference between positive and negative outcomes.

To achieve positive outcomes for patients treated with immunotherapy, coordinated care among a patient’s multiple providers and adequate patient education is necessary to manage potential toxicities during and after treatment. As the number of cancer immunotherapy survivors continues to grow, so too does the recognition of their unique needs in survivorship and beyond. To address the current gap in survivorship resources, ACCC’s Immuno-Oncology Institute offers numerous tools and resources to meet the complex needs of this patient population, including:

• ACCC's Physician Talking Points provide a helpful guide for physicians treating patients with immunotherapies. They cover setting goals and expectations, symptom and side effect management, sexual health, financial distress, care transitions, and other topics. Suggested patient questions can help clinicians raise these important topics with their patients.

   

• ACCC’s Survivorship Care Plan for Immuno-Oncology Therapies is designed to supplement current tools and templates already in use to further enhance care coordination and the patient experience. This brief patient assessment enables clinicians to record a patient’s treatment summary, follow-up care plan, and physical and psychosocial needs to ease care transitions. While most side effects from immunotherapy present within a few months, some may not present for up to several years after treatment discontinuation. Another tool, the Immuno-Oncology Care Transition Summary provides a more detailed account of a patient’s previous treatments, side effects, clinical trials (when relevant), and ongoing treatment/maintenance.

   

• Finally, ACCC’s Immuno-Oncology Survivor Support Resources provides a list of additional supportive resources for patients in survivorship and their families, including the phone numbers, URLs, and phone-based apps for various patient organizations. A list of cancer type-specific advocacy organizations, online support groups, peer-to-peer programs, and in-person support groups is also included.

Additional Tools

• IO Wallet Cards: In the event of a patient trip to an emergency department (ED), clear communication and care coordination between ED clinicians and a patient’s treating oncologist are critical to expedite appropriate management of potential immune-related adverse events (irAEs). Providing IO patients with a medical wallet card that states the individual is being treated with immunotherapy for cancer, the warning signs of irAEs, and 24/7 physicians contact information eases the burden on patients and caregivers in an emergent situation. The IO wallet card, available as a downloadable print-ready PDF, enables cancer programs and practices to easily create additional copies for multiple patients.

   

• Immune-related Adverse Events (irAEs) Workup Guidelines: Immune-related adverse events can be difficult to distinguish from other conditions. Knowing how and when to admit an immunotherapy patient, treat their symptoms, or withhold ICI therapy can be difficult to determine. However, in recent years, multiple organizations (including ASCO, ESMO, NCCN, and SITC) have published formal recommendations, or workup guidelines, for managing irAEs. This web-based too enables you to quickly access formal recommendations for managing irAEs by clicking on the organ system of interest to display the common irAEs for which guidelines are available.

   

• Survivorship in the Era of IO Webinars/Lecture Series: In these videos, expert panels discuss the unique survivorship needs of IO patients, including improving care coordination and communication within the multidisciplinary team and enhancing patients’ psychosocial and physical well-being.