Objective:

To evaluate the burden of chronicity, challenges associated with corticosteroid therapy for immune-related adverse events (irAEs), and the total clinical workload regarding their medical management.

Approach:

• Patient Data Collection: Retrospective data collection from 231 patients treated with immune checkpoint inhibitors (ICIs) at Kuopio University Hospital between January 1, 2015, and December 31, 2022.
• Definition of irAEs: irAEs were defined as toxicities induced by ICI therapy, graded using the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.
• Contact Analysis: Analysis of irAE-related contacts with medical oncologists, including outpatient visits, telephone calls, silent consultations, and hospitalizations.

Key Findings:

• 61% of patients with irAEs experienced chronic toxicity lasting over 12 weeks.
• 43% of irAEs required corticosteroid treatment, with 49% undergoing prolonged therapy exceeding 12 weeks.
• Management of irAEs necessitated an average of 5.3 contacts with a medical oncologist per irAE.

Interpretation:

The study highlights the significant clinical burden and complexity of managing chronic irAEs in cancer patients treated with ICIs.

Limitations:

• The study was retrospective and excluded patients involved in clinical trials.
• Chronicity definitions may vary, affecting the generalizability of findings.

Conclusion:

Understanding the long-term effects and clinical workload associated with irAEs is crucial for effective management in ICI therapy.