{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:23:43Z","timestamp":1789395823169,"version":"build-2803163510"},"reference-count":16,"publisher":"Harborside Press, LLC","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (irAEs). Methods to obtain real-time multidisciplinary input for irAEs that require subspecialist care are unknown. This study aimed to determine whether a virtual multidisciplinary immune-related toxicity (IR-tox) team of oncology and medicine subspecialists would be feasible to implement, be used by oncology providers, and identify patients for whom multidisciplinary input is sought. <jats:bold>Patients and Methods:<\/jats:bold> Patients treated with ICIs and referred to the IR-tox team in August 2017 through March 2018 were identified. Feasibility was defined as receipt of electronic referrals and provision of recommendations within 24 hours of referral. Use was defined as the proportion of referring providers who used the team\u2019s recommendations, which was determined through a postpilot survey. Demographics and tumor, treatment, and referral data were collected. Patient features and irAE associations were analyzed. <jats:bold>Results:<\/jats:bold> The IR-tox team was found to be feasible and used: 117 referrals from 102 patients were received in 8 months, all providers received recommendations within 24 hours, 100% of surveyed providers used the recommendations, and 74% changed patient management based on IR-tox team recommendations. Referrals were for suspected irAEs (n=106; 91%) and suitability to treat with ICIs (n=11; 10%). In referred patients, median age was 64 years, 54% were men, 13% had prior autoimmunity, and 46% received ICI combinations versus monotherapy (54%). The most commonly referred toxicities were pneumonitis (23%), arthritis (16%), and dermatitis (15%); 15% of patients had multisystem toxicities. Multiple referrals were more common in those treated with combination ICIs (odds ratio [OR], 6.0; <jats:italic>P<\/jats:italic>=.035) or with multisystem toxicities (OR, 8.1; <jats:italic>P<\/jats:italic>=.005). The IR-tox team provided a new multidisciplinary forum to assist providers in diagnosing and managing complex irAEs. This model identifies educational and service needs, and patients with irAEs for whom multidisciplinary care is most sought. <jats:bold>Conclusions:<\/jats:bold> A virtual multidisciplinary toxicity team for irAEs was a feasible and used service, and facilitated toxicity identification and management.<\/jats:p>","DOI":"10.6004\/jnccn.2018.7268","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T18:24:07Z","timestamp":1560795847000},"page":"712-720","source":"Crossref","is-referenced-by-count":98,"title":["A Multidisciplinary Toxicity Team for Cancer Immunotherapy\u2013Related Adverse Events"],"prefix":"10.6004","volume":"17","author":[{"given":"Jarushka","family":"Naidoo","sequence":"first","affiliation":[{"name":"aBloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Zhang","sequence":"additional","affiliation":[{"name":"aBloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan J.","family":"Lipson","sequence":"additional","affiliation":[{"name":"aBloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.","family":"Forde","sequence":"additional","affiliation":[{"name":"aBloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Suresh","sequence":"additional","affiliation":[{"name":"bDepartment of Medicine, Division of Pulmonary and Critical Care Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall F.","family":"Moseley","sequence":"additional","affiliation":[{"name":"cDepartment of Medicine, Division of Endocrinology, Diabetes & Metabolism,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Mehta","sequence":"additional","affiliation":[{"name":"dDepartment of Medicine, Division of Infectious Diseases,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn G.","family":"Kwatra","sequence":"additional","affiliation":[{"name":"eDepartment of Medicine, Division of Dermatology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa M.","family":"Parian","sequence":"additional","affiliation":[{"name":"fDepartment of Medicine, Division of Gastroenterology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K.","family":"Kim","sequence":"additional","affiliation":[{"name":"fDepartment of Medicine, Division of Gastroenterology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Probasco","sequence":"additional","affiliation":[{"name":"gDepartment of Medicine, Division of Neurology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanne","family":"Rouf","sequence":"additional","affiliation":[{"name":"hDepartment of Medicine, Division of Cardiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E.","family":"Thorne","sequence":"additional","affiliation":[{"name":"iDepartment of Medicine, Division of Ophthalmology,"},{"name":"jDepartment of Epidemiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Shanbhag","sequence":"additional","affiliation":[{"name":"aBloomberg-Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center at Johns 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