Immuno-Oncology Initiative Seeks to Overcome Implementation Challenges

The growing use of immunotherapy in oncology has confronted many oncologists in community practices with challenges regarding its implementation.

According to Jennie Crews, of Seattle Cancer Care Alliance and the Association of Community Cancer Centers (ACCC), education and advocacy in favor of immuno-oncology are needed on a national level. That’s where the ACCC Immuno-Oncology Institute comes in.

At the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, Crews sat down with CURE to discuss the new initiative and how it aims to help educate oncologists and advocate for patients so that these treatments that use the body’s immune system to fight cancer are more widely used in community practice as well.

CURE: Can you tell us about the ACCC Immuno-Oncology Institute?

Crews: The ACCC is an organization that’s been around for a number of years now with the purpose of providing education and advocacy for the entire oncology team. When the advent of immuno-oncology occurred, we realized that there would be a need to educate our community practitioners on how to implement (immuno-oncology) into their practices.

What is the goal of this initiative?

The (Immuno-Oncology) Initiative has focused on a number of areas to assist practices with implementation of these breakthrough therapies, including how to provide education to all of the staff, how to implement ways to manage toxicities, how to advocate for patients to get access to these treatments and how to meet some of the challenges around reimbursement.

Can you discuss the rise of immuno-oncology and expand on some of the real-world implementation issues that the initiative hopes to address?

We’ve evolved over time in what we’ve been tackling, and as the (immuno-oncology) drugs have evolved and their use has increased, I think most practices in the country are familiar enough with (immuno-oncology) therapy that they’ve been able to overcome some of the initial challenges of bringing these drugs into routine cancer care.

Some of the things that we’re facing now include how to extend info about management of toxicities beyond the traditional cancer team, to include specialists like ER physicians or pulmonologists or gastroenterologists who may also be seeing patients who are undergoing these treatments when they have side effects or toxicities.

Other challenges are what do we do with the combined (immuno-oncology) drugs? We’re combining them with chemotherapy and each other, and this presents new challenges around access for patients and around reimbursement for practices.

And finally, with the advent of (chimeric antigen receptor)-T (cell therapy), right now it’s limited to a number of centers that have accreditation to provide this very complex treatment. But we suspect that in the future this may be a more widely used modality of care, so how do we start to prepare for that? And now, when patients are going to specialized centers of care and coming back to the community, how do we co-manage those patients?