Immunotherapy Late Effects Project

Educating the generalist and specialist workforce in Late Effects in people with cancer treated with immunotherapy across Wessex in Primary Care

The project was funded by HEE SE Cancer and Diagnostics Programme
January to March 2023

This short project centred on education around the late effects of immunotherapies, focusing on primary care and community teams’ awareness.

Immunotherapies are relatively new treatments that use the immune system to find and attack cancer cells, with different types of immunotherapy using the immune system in various ways. These treatments have dramatically changed the way cancer is treated and vastly improved outcome for many patients.

The side effects are very different to chemotherapy. Importantly, immunotherapy can cause inflammatory and autoimmune complications that can affect any part of the body. Most side effects occur within 6-9 months but can emerge up to 3 years after treatment. Immune related endocrinopathies affect a small percentage of all patients and immune checkpoint inhibitors have been causatively associated with hypophysitis, hypopituitarism and adrenal insufficiency. Patients may present with non-specific symptoms, resulting in diagnostic challenge as they may resemble other causes such as brain metastasis or underlying disease.

Immunotherapy has transformed the way cancer is treated and is likely to develop further. WCA is committed to enabling PCN staff to stay updated with current knowledge and to empower patients with access to appropriate knowledge, ensuring best practice across Wessex.

The aims of the project were to i). explore a range of perspectives looking at the awareness and confidence of Primary Care Clinicians recognising late side effects of immunotherapies, ii). review the information available and share in an accessible way iii). gain a greater understanding of the information and education required by primary care on late side effects of immunotherapies.

A consultation process was implemented, engaging with a purposeful sample of primary care staff, using a five part methodological approach to gather data: