Oncology is moving rapidly into the Immunotherapy era. The chemotherapy suite is now referred to as the “Infusion/Day” suite since an increasing proportion of infusions are for immunotherapy agents. The Central West Cancer Care Centre (CWCCC) services a region 150km from Orange, NSW and provides cancer services to 140,000 people. There are 2 satellite Day suites and 2 centralised Day suites.
The incidence of immunotherapy administration is rapidly growing as more agents are approved across increasing tumour types. In 2013 at the CWCCC, there were no immunotherapy administrations compared to 244 (4%) in 2017. This increase will accelerate and will have direct resourcing implications for both the clinic and the Day suite. There are many factors explaining the growth including prolonged duration of immunotherapy regimens, improved cancer outcomes and the expansion of these agents across more tumour types.
The second core issue is that these immunotherapy agents have heralded in an entirely new class of adverse events (AEs), known as immune related AEs. Consequently oncologists and other clinicians (cancer nurses, GPs, sub-specialists, emergency physicians, intensivists) must expand their differential diagnoses when cancer patients present with side effects. Data on regional and metropolitan immunotherapy patients will be presented including: demographics, treatment details, treatment intent, cancer outcomes, time to treatment failure. Data will also be presented on irAEs including the specific toxicities, grade and their subsequent management. The impact on the flow within the clinic and the Day suite will also be discussed.