{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:17:15Z","timestamp":1747185435520,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T00:00:00Z","timestamp":1565049600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The introduction of the cytotoxic T\u2010lymphocyte\u2010associated antigen 4 (CTLA\u20104) and programmed cell death protein 1 (PD\u20101) immune checkpoint inhibitors and their subsequent listing on the Pharmaceutical Benefits Scheme for use in metastatic melanomas, renal cell carcinomas and non\u2010small\u2010cell lung cancers has resulted in routine use of these agents in oncology practices, including in regional areas. Although immunotherapeutic agents generally have a favourable toxicity profile compared to chemotherapy, they can provoke immune\u2010related adverse effects (irAE) caused by an unregulated and hyperstimulated immune response. Some of these effects can be serious and life\u2010threatening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare the utilisation of immunotherapy and the rates, management and outcomes of irAE between a regional oncology service and a tertiary service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the medical records for all patients treated with immunotherapy in the participating services for the 5\u2010year period from 31 July 2012 to 31 July 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data demonstrated that rates of immunotherapy use are both similar and increasing across the tertiary and regional services. The rates, types and severity of irAE are equivalent and in concordance with pre\u2010existing literature. Immune\u2010related adverse events appear to be identified and treated earlier in the regional service with the corresponding reduction in the duration of immunosuppression and requirement for inpatient management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of immunotherapy in a regional setting is safe and equivalent to that of a tertiary centre.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14235","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T04:43:31Z","timestamp":1548737011000},"page":"1010-1015","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of immunotherapy use and management of toxicities in regional and tertiary settings"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8124-5816","authenticated-orcid":false,"given":"Brett","family":"Hamilton","sequence":"first","affiliation":[{"name":"Liverpool Cancer Therapy Centre  Sydney New South Wales Australia"},{"name":"Central West Cancer Care Centre, Orange Health Service  Sydney New South Wales Australia"},{"name":"Alan Coates Cancer Centre, Dubbo Base Hospital  Dubbo New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kay","family":"Xu","sequence":"additional","affiliation":[{"name":"Liverpool Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Honeyball","sequence":"additional","affiliation":[{"name":"Alan Coates Cancer Centre, Dubbo Base Hospital  Dubbo New South Wales Australia"},{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bavanthi","family":"Balakrishnar","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Zielinski","sequence":"additional","affiliation":[{"name":"Central West Cancer Care Centre, Orange Health Service  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,6]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"S11","article-title":"High\u2010dose recombinant interleukin\u20102 therapy in patients with metastatic melanoma: long\u2010term survival update","volume":"6","author":"Atkins MB","year":"2000","journal-title":"Cancer J Sci Am"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0000000000000149"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510360033032"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.7.2105"},{"key":"e_1_2_6_6_1","first-page":"488","article-title":"Treatment of metastatic melanoma: an overview","volume":"23","author":"Bhatia S","year":"2009","journal-title":"Oncology (Williston Park, NY)"},{"key":"e_1_2_6_7_1","first-page":"619","article-title":"Phase II trials of recombinant leukocyte a interferon in disseminated malignant melanoma: results in 96 patients","volume":"70","author":"Creagan ET","year":"1986","journal-title":"Cancer Treat Rep"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.3216"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2370"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30366-7"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504030"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt291"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412082"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31601-X"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507643"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504627"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01281-7"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606774"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510665"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0349-3"},{"key":"e_1_2_6_21_1","first-page":"30","article-title":"Identification and management of toxicities from immune checkpoint\u2010blocking drugs","volume":"28","author":"Teply BA","year":"2014","journal-title":"Oncology (Williston Park, NY)"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.6750"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.1051"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000358"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx008"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-0187"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-1136"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2015.11.016"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2017.00049"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27969"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv623"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fimj.14235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.14235","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.14235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T11:25:07Z","timestamp":1694258707000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.14235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/imj.14235"],"URL":"https:\/\/doi.org\/10.1111\/imj.14235","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"2018-08-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}