Immunotherapy Moves to Community Cancer Setting

Immunotherapy Moves to Community Cancer Setting

Zosia Chustecka

Finally what we dreamed would occur in the 1980 one day, has come to pass and will not be stopped. A first-of-its-kind initiative aimed to facilitate the adoption of immuno-oncology in the community cancer setting has just been launched by the Association of Community Cancer Centers (ACCC )


Immunotherapy is the buzzword in oncology these days. Having heard about dramatic responses, patients are asking about these therapies, and oncologists within community settings are now starting to use these new therapies. But this is a whole new field of oncology ― these therapies are quite different from anything that has gone before, and they have unique patterns of responses and toxicities, so physicians need to get up to speed on this new branch of therapy before they can use it.

This is where the ACCC is stepping in with its new initiative, entitled the Institute for Clinical Immuno-Oncology (ICLIO), with e-programs and other resources available through its website.

Immunotherapy is a “transformational paradigm in cancer treatment,” the ACCC says. The new program will offer education on best practices in all aspects of care: clinical care, deciphering reimbursement, insurance, social work, and supporting patient access to emerging treatment options.

“The purpose of ICLIO is to translate all the interesting information coming out of research into the community setting and to help community oncology teams to implement immunotherapy,” commented president-elect of the ACCC Jennie Crews, MD, from Bellingham, Washington.

In an interview with Medscape Medical News, Dr Crews said the need for an education program was very clear from a recent survey the organization carried out of its members. “We have 20,000 members, who treat around 60% of oncology patients in the United States,” she explained. There are members both at academic centers and in community practices, and they form multidisciplinary cancer teams that include medical oncologists, radiation oncologists, and surgeons, but there are also social workers, administrative staff, and dieticians. “This is a whole oncology team, which makes our organization very unique,” she said.

So far, the new immunotherapies, which include ipilimumab (Yervoy, Bristol-Myers Squibb Company), nivolumab (Opdivo, Bristol-Myers Squibb Company), and pembrolizumab (Keytruda, Merck Sharp & Dohme Corp), have been approved for use in the treatment of melanoma, and recently, nivolumab was also approved for use in lung cancer, but these drugs are showing promise in many other cancer types. Recent data show benefit in renal cell carcinoma, glioma, and head and neck cancer, Dr Crews commented. Some experts have even gone as far as to suggest that immunotherapy may in the future form the “backbone” of cancer therapy, onto which the other treatment modalities would be added. “Research has already addressed the question of what ― now we address the question of how,” she said.

Immunotherapy is “opening a whole new world of oncology,” Dr Crews commented. “The enthusiasm and excitement from research and clinical trials have spilled over into the community, and community docs are eager to use these drugs ― but they have many questions about how to use them, how to sequence the drugs, how to combine them, and how to manage toxicity of these drugs, and financial toxicity is a big part of that,” she said.

“A huge, huge issue is coverage and reimbursement, and then, of course, the patient advocacy aspect ― making sure that patients do have access to these drugs and have coverage for these drugs,” she said.

“ACCC is committed to being a leader in cancer care education by providing the most up-to-date and innovative cancer treatment resources and information to our members,” said ACCC President Steven L. D’Amato, BSPharm, BCOP. “We recognize the critical need for offering immunotherapy in community cancer centers and established ICLIO to empower cancer care providers to address the dynamic intricacies of immune-oncology real-world treatment and delivery.”

The ACC ICLIO is planning a national conference, which is to be held in Philadelphia on October 2, 2015.



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