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Palliative care physicians’ recognition of patients after immune checkpoint inhibitors and immune-related adverse events

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Abstract

Purpose

This study investigated the experience of palliative care physicians (PCPs) and their knowledge and recognition of immune checkpoint inhibitors (ICIs) and immune-related adverse events (irAEs) in clinical practice as well as the need to provide palliative care services for patients after ICI treatments.

Methods

A cross-sectional survey with self-administered questionnaires was conducted between February and April 2020. A total of 759 questionnaires were sent to PCPs in Japan. The changes in the PCPs’ knowledge and recognition of ICIs and irAEs due to the increased experiences of treating patients after ICI treatments were analyzed.

Results

Four hundred ninety-two responses (64.8%) were analyzed. Only 15.0% of respondents had no experience of patients after ICI treatments, while 53.9% had experience of more than six patients. On the other hand, 40% of respondents had no experience of patients with suspected irAEs, while only 13.4% had experience of more than six patients. Respondents with more experience of patients after ICI treatments or those with suspected irAEs had extensive knowledge of ICIs and irAEs, were more confident in treating these patients, and tended to consider irAEs as therapeutic indications. The majority of respondents required guidelines and efficient consultation systems with oncologists.

Conclusion

This study demonstrated that PCPs with experience had extensive knowledge and confidence of ICIs and irAEs and tended to recognize irAEs as therapeutic indications. The establishment of a more intimate relationship between PCPs and oncologists is important for providing better treatment for these patients.

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Acknowledgements

We thank Ms. Masako Ikeda and Ms. Mari Hirata for their secretarial support.

Funding

This work was supported by the Ministry of Health, Labour and Welfare (grant number 19EA1011).

Author information

Authors and Affiliations

  1. Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Yuko Usui, Tomofumi Miura, Kazuhiro Kosugi, Yuko Uehara & Yoshihisa Matsumoto

  2. Division of Palliative Therapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Yuko Usui

  3. Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan

    Takashi Kawaguchi

  4. Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Yuko Uehara & Akio Mizushima

  5. Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    Masashi Kato

  6. Department of Palliative Care, Ken Medical Centre Koseikan, SagaSaga, Japan

    Toshifumi Kosugi

  7. Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Miyuki Sone

  8. Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan

    Naoki Nakamura

  9. Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan

    Mitsunori Miyashita

  10. Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan

    Tatsuya Morita

  11. Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan

    Takuhiro Yamaguchi

  12. Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan

    Eriko Satomi

Authors
  1. Yuko Usui
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  2. Tomofumi Miura
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  15. Eriko Satomi
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Contributions

Yuko Usui: study design; development of questionnaire; analysis; writing manuscript; review; approval of manuscript.

Tomofumi Miura: study design; development of questionnaire; analysis; writing manuscript; review; approval of manuscript.

Takashi Kawaguchi: analysis; review; approval of manuscript.

Kazuhiro Kosugi: development of questionnaire; review; approval of manuscript.

Yuko Uehara: study design; development of questionnaire; review; approval of manuscript.

Masashi Kato: development of questionnaire; review; approval of manuscript.

Toshifumi Kosugi: development of questionnaire; review; approval of manuscript.

Miyuki Sone: development of questionnaire; review; approval of manuscript.

Naoki Nakamura: development of questionnaire; review; approval of manuscript.

Akio Mizushima: development of questionnaire; review; approval of manuscript.

Mitsunori Miyashita: study design; development of questionnaire; review; approval of manuscript.

Tatsuya Morita: study design; development of questionnaire; review; approval of manuscript.

Takuhiro Yamaguchi: study design; review; approval of manuscript.

Yoshihisa Matsumoto: study design; participant enrollment; review; approval of manuscript.

Eriko Satomi: study design; participant enrollment; review; approval of manuscript.

Corresponding author

Correspondence to Tomofumi Miura.

Ethics declarations

Ethics approval and consent to participate

Authors confirmed that the Institutional Review boards of National Cancer Center Hospital did not need any ethical approval. The questionnaire included the check box to declare disagree with participation. Therefore, participants who answered and returned the questionnaire without filling check box were considered to agree with participation.

Consent for publication

A letter of request explained the publication of this study. Therefore, participants who answered and returned the questionnaire were considered to agree with publication.

Conflict of interest

The authors declare no competing interests.

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Usui, Y., Miura, T., Kawaguchi, T. et al. Palliative care physicians’ recognition of patients after immune checkpoint inhibitors and immune-related adverse events. Support Care Cancer 30, 775–784 (2022). https://doi.org/10.1007/s00520-021-06482-5

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