Clinician survey on the value of risk prediction for immune-related adverse events induced by immune checkpoint inhibitors

Introduction Identification of risk factors to predict immune-related adverse events (irAE) is a growing research area. This baseline study explores which factors oncology clinicians consider, perspectives on the value of risk prediction, and how this may impact clinical practice. Methods An electronic survey was developed to explore current practice, perceived value of risk prediction, and a vignette study where respondents selected their preferred treatment at baseline and according to proposed risk. Results Forty responses were analysed from medical oncologists (57.5%), medical oncology trainees (17.5%), nurse specialists (17.5%), and nurse practitioners (7.5%) who practice in various settings. If validated, a risk prediction tool was reported to be useful to tailor education, inform clinic review frequency and post-treatment follow-up. Perceived barriers included cost, timeliness of pre-treatment assessment, and unknown specificity of predicted risk. When confronted with higher predicted irAE risk, clinicians demonstrated a propensity to adjust treatment strategies in favour of single-agent ICI therapy compared to combination ICI. Conclusion Oncology clinicians perceive value in assessing irAE risk prior to commencing ICI, with 80% anticipating impact on patient education. Respondents perceived cost, complexity of assessments, and reliability/accuracy as important requirements for prediction tools. As predicted irAE risk increased, respondents were more likely to prefer less toxic treatment.