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Initiative fuels advancement, access of immuno-oncology in community setting
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The approval and availability of new immunotherapy treatments sparked the need for dissemination of these therapies to patients throughout the cancer care community.
In 2015, the Association of Community Cancer Centers launched the Institute for Clinical Immuno-Oncology (ICLIO) initiative to help advance access to these new therapies, as well as to educate and prepare multidisciplinary cancer care teams to implement immuno-oncology approaches at their centers.
Jennie R. Crews
ICLIO is the only initiative to prepare multidisciplinary cancer care providers for the complex implementation of immuno-oncology in the community setting.
HemOnc Today spoke with Jennie R. Crews, MD, FACP, president of the Association of Community Cancer Centers, and medical director of cancer services of PeaceHealth St. Joseph Medical Center in Bellingham, Washington, about what has been accomplished during the first year of the initiative and how the effort may evolve.
Question: How did the initiative come about?
Answer: The need arose because of the emergence of immunotherapy in oncology. It is a unique modality of therapy. Our membership needed to learn more about it and learn how to use the operative device within their clinics. This is one thing that the ICLIO initiative does well: It helps practices translate the scientific development and operationalize them in their practices.
Q: What was accomplished during the first year?
A: We achieved a number of key milestones. We started by conducting focus groups and establishing an advisory committee comprised of 14 members. The membership is diverse; it includes academic and other physicians from the oncology community, as well as pharmacists, social workers and others. We also conducted surveys within our membership to identify their needs and their level of comfort regarding these new immunotherapies. We published a white paper, we have established a roster of scholars who are experts in immunotherapy research and we have reached over 700 cancer programs. We have done this in a number of ways. One is through an e-newsletter that has reached more 7,000 readers. We also launched an e-course, a webinar series and a website, which achieved more than 11,000 unique page views. We also organized and successfully launched a national conference last fall. We have had a very busy first year.
Q: How will the initiative evolve or expand in the future?
A: There will continue to be a need for our membership, and there are several areas that we hope to develop. There are going to be continued issues around reimbursement, which is likely to calibrate as these therapies become more widely used for more types of cancers. The ICLIO initiative will help our membership with issues related to reimbursement. There are probably going to be ongoing concerns about how to manage these patients in the community setting, particularly as we begin to use combinations of immunotherapies and the increasing need to learn how to deal with toxicities. The ICLIO initiative also is focusing on reaching beyond the traditional cancer team to include other disciplines of care — such as gastroenterologists, endocrinologists and cardiologists — who may be seeing the toxicities of these therapies but may be unfamiliar with those toxicities and how to manage them. We soon will offer preceptorships, which are hands-on experiential learning opportunities to help develop delivery models.
Q: What have the most recent data suggest ed in terms of outcomes for patients undergoing immunotherapy treatment?
A: Some of the most exciting data shows a subset of patients that are experiencing long-term survival and disease control with immunotherapy. There is excitement around the expansion of these agents into additional tumor types and getting more data on their effectiveness. There is also the idea of combination therapy.
Q: What sort of challenges remain with immunotherapy treatment?
A: One challenge is to identify who will best be served and who will have the best response with these agents. There also is a challenge in how we sequence these agents and combine them. Then there are ongoing challenges in identifying and managing toxicities of immunotherapies.
Q: How might future research address these challenges?
A: Most of the future research will focus on identifying the best markers of benefits of immunotherapy, as well as incorporating newer agents and combining immunotherapy with other forms of treatment.
Q: What advice would you offer physician s who treat patient s with immunotherapy?
A: There really needs to be a team approach when incorporating immunotherapy. This is especially true in the community practice. It entails bringing together the treatment from nurses, social workers and financial counselors because of all the issues with incorporating immunotherapy into a patient’s treatment regimen. The other piece of advice that I would give is to use the resources that our agency has available on the ICLIO website at accc-iclio.org. One can access expert opinion and tactful information regarding the operational issues within their practice. – by Jennifer Southall
For more information:
Jennie R. Crews , MD , FACP, can be reached at PeaceHealth St. Joseph Medical Center, 2901 Squalicum Parkway, Bellingham, WA 98225; email: lgardner@accc-cancer.org.
Disclosure: Crews reports no relevant financial disclosures.