Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Feasibility, acceptability and utility of a pilot nurse-led survivorship program for people with metastatic melanoma (MELCARE) (#399)

Julia Lai-Kwon 1 , Brooke Kelly 2 , Sarah Lane 1 , Rebecca Biviano 1 , Iris Bartula 1 , Frank Brennan 3 , Ingrid Kivikoski 4 , Jake Thompson 5 , Haryana Dhillon 6 7 , Alexander M Menzies 5 8 9 10 , Georgina V Long 1 8 9 10
  1. Melanoma Institute Australia, Wollstonecraft, NSW, Australia
  2. Melanoma Patients Australia, Varsity Lakes, QLD, Australia
  3. Consumer Representative, Sydney, NSW
  4. Consumer representative, Brisbane, QLD, Australia
  5. Melanoma Institute Australia, Wollstonecraft, NSW, Australia
  6. Psycho-oncology Cooperative Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
  7. Centre for Medical Psychology and Evidence-Based Decision Making, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
  8. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  9. Mater Hospital, North Sydney, NSW, Australia
  10. Royal North Shore Hospital, Sydney, NSW, Australia

Purpose: Immune checkpoint inhibitors (ICI) and targeted therapy (TT) have improved the survival of people with metastatic melanoma (PwMM).  MELCARE is a nurse-led survivorship program for PwMM who are long-term responders to ICI/ TT involving two telehealth consultations three months apart, needs assessment using the NCCN Distress Thermometer (DT) and Problem List, and creation of a survivorship care plan.  We assessed its feasibility, acceptability and utility.

Methods: PwMM >18-years, >6 months post initiation of ICI with a complete response (CR) on computed tomography (CT) or >1 year post initiation of ICI with a complete metabolic response on positron emission technology scan and a CR/ partial response (PR) on CT or >2 years post initiation of TT with a CR on CT, able to have a telehealth consultation and complete online surveys were recruited.

Results: 31/54 (57%) people consented.  Participants were male (21, 68%), median age 67 (range: 46-82), 11 (35%) receiving/ had received ipilimumab and nivolumab, 27 (87%) had ceased treatment. Feasibility was demonstrated with 97% completing MELCARE.  Utility was demonstrated on a customised survey and supported by a reduction in the mean DT score.  Acceptability was demonstrated on 3/4 items on the Acceptability of Intervention Measure (AIM).  The rate of consent was lower than expected (31/54, 57%). 

Conclusion: MELCARE was feasible and acceptable with high levels of utility.  This is the first survivorship program designed for people with metastatic cancer.  It provides a model for addressing unmet supportive care needs in this emerging survivor group.Future studies should consider its optimal timing, resourcing and cost-effectiveness.