Specialized Teams Improve Safety as Immunotherapy Use Surges in Cancer Care

As immunotherapy continues to transform cancer treatment, multidisciplinary teams are proving essential for managing the potentially severe toxicities that accompany these therapies, according to an article published in the American Society of Clinical Oncology Educational Book.

“This article explores best practices for developing multidisciplinary immunotherapy toxicity services across various care settings,” explained Danielle Brazel, MD, Division of Hematology and Oncology, Scripps Clinic in La Jolla, CA, and coauthors.

Over the past decade, immune checkpoint inhibitors (ICIs) have expanded dramatically, with US Food and Drug Administration (FDA)-approved indications rising from 1.5% of cancer patients in 2011 to 56.5% in 2023. These therapies activate the immune system to attack cancer, but in doing so, they can also cause immune-related adverse events (irAEs) affecting nearly any organ. Although many irAEs are mild and resolve spontaneously, up to 55% can be severe, with conditions such as myocarditis or pneumonitis carrying a risk of fatality. The need for specialized, coordinated care models is clear.

Academic medical centers and community hospitals alike are developing immunotherapy toxicity services to recognize and manage irAEs early. These programs integrate oncologists with subspecialists in endocrinology, cardiology, pulmonology, and more. Teams follow national guidelines, implement standardized protocols, and use tools like electronic health record alerts to streamline diagnosis and treatment. Some institutions, such as Massachusetts General Hospital and Johns Hopkins, have developed 24/7 inpatient consult services, while others are creating outpatient urgent care pathways to reduce hospitalizations. To scale access beyond academic hubs, "hub-and-spoke" models connect community clinics to specialty centers through telemedicine, virtual tumor boards, and real-time consults. National initiatives, such as ASPIRE and STORIES, are also advancing education, research, and patient advocacy, while the recent creation of irAE-specific ICD codes will enable better tracking and data collection.

“As immunotherapy has transformed the therapeutic landscape, the rise in irAEs necessitates improved management approaches on the basis of international guidelines for irAEs to ensure patient safety and treatment efficacy,” concluded the study authors.

Reference

Brazel D, Kazakova V, Fay M, et al. Connecting the dots: practical strategies for academic and community oncology synergy to advance multidisciplinary management in immunotherapy toxicity care. Am Soc Clin Oncol Educ Book. 2025;45(3):e473080. doi:10.1200/EDBK-25-473080