IMMUNOTHERAPY: MANAGING THE BREAKTHROUGH

INTRO PLENARY EXPERT PANEL SESSION

The meeting was introduced by Dr Veronique Walsh and ISA chair Professor Pierre Coulie. Medical Oncologist Professor Ahmad Awada then kicks off with an overview of how far we have come with immunotherapy over the last decade and how resistance to immunotherapy can be overcome with the use of combination treatments. He then introduces an expert panel who handle some hot topics. Pathologist Professor Patrick Pauwels gives an update on biomarkers and medical oncologist Dr Sandrine Aspeslagh on the use of corticosteroids with checkpoint inhibitors. Medical oncologist Dr Stefan Rauh answers some questions on duration of treatment and the possibility to re-challenge and/or retreat.

CARDIO-ONCOLOGY

Medical oncologist Professor Guy Jerusalem and cardiologist Dr Marie Moonen present on how to manage patients with a history of cardio-vascular disease who are on immunotherapy. This includes what should be done in the initial work-up and how to monitor patients.

They also give an insight into the challenges in diagnosis and treatment of acute cardiac toxicity (myocarditis, pericarditis) and discuss how to manage patients with immunotherapy after cardiovascular side effects.

MANAGING PATIENTS WITH UNDERLYING AUTOIMMUNE DISEASE

In this interactive workshop, rheumatologist Professor Bernard Lauwerys and thoracic oncologist Professor Karim Vermaelen discuss, through a patient case study, how to manage patients with underlying autoimmune disease who are on immunotherapy. They also cover the pathophysiology underlying the development of immune-related adverse events (irAEs) under immune checkpoint inhibition, tolerability data for immune checkpoint inhibitors in this patient population as well as potential clinical or biological biomarkers that could predict the risk of developing irAEs.

THE CHALLENGE OF SURVIVORSHIP CARE IN THE FIELD OF IMMUNOTHERAPY

Little is known about the psychosocial wellbeing, neurocognitive function, and quality of life (QOL) of cancer patients on checkpoint inhibitors. Long-term survivorship is a novel issue in the field of immunotherapy.

Psychiatrist Dr Anne Rogiers, moderated by medical oncologist Professor Bart Neyns, presents the first results of psycho-social outcome in metastatic melanoma survivors treated with immune checkpoint inhibitors. She also discusses the challenge of identifying patients who need referral to mental health care and gives some insights in cognitive disturbances and possible treatment interventions.

USE OF CHECKPOINT INHIBITORS (CPI) IN PATIENTS WITH SPECIFIC MEDICAL CONDITIONS AND CHALLENGES RAISED BY THERAPIES

Can CPI treatment be considered as an option in patients with cancer who have undergone solid organ transplant? What about the use of CPI in the elderly or in patients with brain metastases, Hep B or HIV? Can Flu vaccine be given to patients receiving CPI ? Medical oncologist Professor Ahmad Awada gives a nice overview of what is known so far.

After these questions, medical oncologist Professor Jean-Pascal Machiels brings up the topic of hyperprogression: truth or hype? He also gives his view on what to know about pseudoprogression.

PATIENT EDUCATION

An important theme in treatment with immunotherapies is the education of patients. In this workshop, moderated by thoracic oncologist Professor Johan Vansteenkiste, Hematologist Professor Tessa Kerre presents Immuno-T, a communication tool and specialized onconurses Marie Vandevelde and Annemarie Coolbrandt present a digital tool that can support patients through their therapy. Dr Stefan Rauh completes this session by giving advice on minimal messaging in patient education if no specific tools or support are in place.

MANAGING IMMUNE-RELATED ADVERSE EVENTS: FOCUS ON ENDOCRINE SYSTEM

In this workshop Dr Sandrine Aspeslagh, as an expert in managing adverse events focuses on hypophysitis and why it should always be considered and well explored in case of unexplained fatigue.

In addition, some key home messages on skin toxicity from dermatologist Professor del Marmol can be found in this presentation

OUTRO PLENARY EXPERT PANEL SESSION

After all workshops the audience came back to the plenary room for the last panel expert session moderated by digestive oncologist Professor Eric Van Cutsem.

He asks Professor Rik Schots to give an overview of the use of CAR-T in hematological malignancies. Professor Bart Neyns explains I-O resistance and the rationale behind combining agents to improve outcome for patients.

Immunology expert Professor Pierre Coulie also provides his view on this from a scientific perspective.