Abstract A096: Impact of a multidisciplinary immune-related adverse event (irAE) tumor board in patients (pts) receiving immune checkpoint inhibitors (ICI)
Authors: Brihn Lesil , Calabrese Cassandra , Zhou Keren , Smith Michael , Abdoh Mamoun , Kunchok Amy , Philpott Jessica , Junna Shilpa , Kabbur Gowri , Owoyemi Itunu , Ornstein Moshe , Moore Halle , Pennell Nathan , Truong Thach-Giao , Isaacs James , Ma Wen , Funchain Pauline , Kennedy Lucy Boyce 
Published: February 2025

Abstract
Background: IrAEs are common complications of ICI therapy and can have diverse manifestations, affecting nearly any organ system and often requiring multi-disciplinary care. An institutional irAE tumor board is an effective tool to facilitate multidisciplinary collaboration and expedite care of these pts. We report the clinical application of our institutional irAE tumor board. Methods: We performed a retrospective review of pts discussed at our multidisciplinary irAE tumor board at Cleveland Clinic Taussig Cancer Center since establishment of irAE tumor board in 2017. The irAE tumor board meets virtually twice monthly. A medical oncologist attends each irAE tumor board. Our genomic data scientist reviews requested cases in advance, invites the requested subspecialists, and coordinates availability of the subspecialists and presenting physician for each pt. Data regarding irAEs and tumor board recommendations were collected using the electronic medical record system. Results: Between September 2017 and October 2024, 144 pts (74 male, 70 female) were discussed at irAE tumor board. Most common primary malignancies were melanoma (56%, 80/144), lung cancer (18%, 26/144), renal cell carcinoma (11%, 16/144), and breast cancer (6%, 9/144). Inclusion of pts with breast cancer increased over time, reflecting the evolving landscape of oncology treatment, with 1 pt with breast cancer presented in 2018, 0 from 2019-2021, 2 in 2022, 3 in 2023, and 3 in 2024. Fourteen unique medical specialties participated. Most common irAEs discussed were gastrointestinal, including colitis, hepatitis, gastritis, and pancreatitis (38%, 55/144). Other common irAEs discussed included rheumatologic (13%, 20/144), neurologic (13%, 19/144), and pulmonary (9%, 13/144). For 15 (10%) pts, the irAE tumor board request was placed for multiple specialties due to irAE affecting &gt; 1 organ system. For 93 pts (65%), a formal consult to the requested specialty was placed at recommendation of tumor board discussion. Sixty patients (42%) received at least 1 dose of ICI after being discussed at irAE tumor board. The fraction of pts who received at least 1 dose of ICI after presentation at irAE tumor board in each year was as follows: 2017: 3/12 (25%), 2018: 10/31 (32%), 2019: 6/15 (40%), 2020: 4/9 (44%), 2021: 8/28 (28%), 2022: 9/17 (53%), and 2023: 9/18 (50%). Conclusion: Our institutional irAE tumor board provides a forum for multidisciplinary collaboration, which streamlines efficient, high-quality care in pts with irAEs. A high fraction of pts received at least 1 dose of ICI after irAE tumor board discussion, and, in general, the percentage of pts who received ICI rechallenge increased numerically over time. This care model facilitates evidence-based care for this pt population and may also contribute to safe and timely ICI rechallenge in appropriate pts. Based on the clinical need we identified through irAE tumor board, our institution opened a multidisciplinary pharmacovigilance clinic, which serves pts with toxicities from their cancer treatments.
Citation Format: Lesil Brihn, Cassandra Calabrese, Keren Zhou, Michael Smith, Mamoun Abdoh, Amy Kunchok, Jessica Philpott, Shilpa Junna, Gowri Kabbur, Itunu Owoyemi, Moshe Ornstein, Halle Moore, Nathan Pennell, Thach-Giao Truong, James Isaacs, Wen Ma, Pauline Funchain, Lucy Boyce Kennedy. Impact of a multidisciplinary immune-related adverse event (irAE) tumor board in patients (pts) receiving immune checkpoint inhibitors (ICI) [abstract]. In: Proceedings of the AACR IO Conference: Discovery and Innovation in Cancer Immunology: Revolutionizing Treatment through Immunotherapy; 2025 Feb 23-26; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Immunol Res 2025;13(2 Suppl):Abstract nr A096.