Episode 8 - Immunotherapy and Pathways: Safety Considerations

In this segment, experts Peter Salgo, MD; Ira M. Klein, MD, MBA, FACP; Bryan Loy, MD; and Irwin W. Tischler, DO, discuss immunotherapy options and their potential in the treatment of many types of cancer. The panelists also consider how to evaluate the safety of a treatment when used as part of a pathway.

Although targeted agents and immunotherapies have not yet been incorporated into pathways, the use of these agents is reimbursed when used in appropriate patients, notes Dr Tischler. Dr Klein adds that an important part of using pathways is gathering data from providers on treatment choices that are outside of a pathway. These data should be collected and providers should be given feedback on their nonadherence to pathways, to help drive value.

Dr Salgo adds that when measuring value, safety is an important consideration. Dr Klein explains that safety is a key reason for the establishment of pathways, which are designed to help put “guardrails” on the use of evidence-based medicine.

Dr Loy adds that when reviewing the safety of immunotherapeutic options, or oncology drugs in general, it is important to consider the treatment plan as a whole, including use of support drugs (eg, antiemetics). The total cost of care should be considered, including data on avoidable consequences, such as visits to the emergency department.