Time is of the Essence: Avoiding Delays in Identification and Management of irAEs

This activity is part of a series


Kerry L. Reynolds, MD
Assistant Professor of Medicine Harvard Medical School
Director, Severe Immunotherapy Complications (SIC) Service
Clinical Director, Inpatient Cancer Services, Massachusetts General Hospital Cancer Center
Boston, MA
Kerry L. Reynolds, MD

Dr. Kerry Reynolds is an oncologist at the Massachusetts General Hospital Cancer Center and Assistant Professor of Medicine at Harvard Medical School. She currently serves as the Director of the Severe Immunotherapy Complications (SIC) Service and the Clinical Director for Inpatient Cancer Services at Mass General Cancer Center. She joined the Harvard Medical School faculty in 2014, after completing her residency and chief residency at Massachusetts General and fellowship training in Oncology at Dana-Farber/Partners Cancer Care.

The SIC Service is the first program of its kind in the country. Every hospitalized patient at Mass General Cancer Center who has received immunotherapy and is suspected to be experiencing an immune-related adverse event (irAE) is seen by one of the Service’s dedicated oncologists, resulting in unparalleled care for this type of toxicity. Under the leadership of Dr. Reynolds, the SIC Service now provides care to a significant number of patients every year and has grown to comprise more than 50 clinicians and researchers across 19 different areas of the hospital, including subspecialists from oncology, cardiology, dermatology, gastroenterology, and many more relevant disciplines.

In addition to providing clinical care, supervising and educating trainees, and participating in administrative affairs, Dr. Reynolds leverages the work of the SIC Service to conduct research on the severe toxicities associated with immunotherapy. Her ultimate goal is to improve the lives of patients undergoing immunotherapy by uncovering irAE predictors and biomarkers, characterizing the clinical presentations of irAEs, developing best practices for managing irAEs, and elucidating the mechanisms that drive irAEs in order to develop novel therapies. To pursue this goal, she is working with Dr. Alexandra-Chloe Villani to systematically collect blood and tissue samples from patients with irAEs and analyze them using cutting-edge technologies. Dr. Reynolds has also authored numerous peer-reviewed publications and several book chapters, and she was lead editor of Facing Immunotherapy: A Guide for Patients and Their Families.

Rebecca Castner, PharmD, BCACP, AAHIVP
Clinical Pharmacy Specialist, Ambulatory Care
Rush University Medical Group - Regional Clinics
Chicago, IL
Rebecca Castner, PharmD, BCACP, AAHIVP

Dr. Rebecca Castner (she/her) is a clinical pharmacy specialist with board certification in both ambulatory care pharmacy and HIV pharmacy practice. Throughout her 10+ years in practice, she has provided subject matter expertise in the areas of outpatient psychiatric pharmacy, integrative medicine, sexually transmitted infection treatment and prevention, gender-affirming care, and mindfulness. She currently serves as the embedded ambulatory care clinical pharmacist within six regional primary care clinics at Rush University Medical Center in the Chicagoland area.

Michael Dougan, MD, PhD
Assistant Professor of Medicine
Massachusetts General Hospital
Harvard Medical School
Boston, MA
Michael Dougan, MD, PhD

Dr. Dougan is an Assistant Professor of Medicine at Massachusetts General Hospital and Harvard Medical School and is the Director of the Immunotherapy Mucosal Toxicities Program at Massachusetts General Hospital. He received his MD and PhD from Harvard Medical School, completing his dissertation work in Immunology with Dr. Glenn Dranoff at the Dana-Farber Cancer Institute. Dr. Dougan’s research aims to translate findings from a detailed analysis of the immune mechanisms driving immunotherapy toxicities into novel treatment strategies both for malignancies and for inflammatory diseases of gut.


Statement of Need

Pharmacists in non-oncology settings and not involved in direct cancer care of patients are more commonly encountering patients who are receiving or who have received an immune checkpoint inhibitor (ICI). Timely recognition and management of immune-related adverse events (irAEs) is needed to avoid progression of mild or moderate irAEs to more severe events and to avoid disruptions in ICI treatment. It is crucial that pharmacists working as part of a multidisciplinary team recognize the signs and symptoms of irAEs and triage patients experiencing these reactions to appropriate care levels based on irAE severity. Pharmacists should implement guideline-directed treatment strategies for irAE management and ensure patients are connected to their oncology treatment team for appropriate outpatient monitoring.

In this CME Outfitters BriefCase, expert faculty will guide learners through a patient case involving an initial presentation of an irAE within the ambulatory care setting. This program will provide guidance to pharmacists working within a multidisciplinary care team on strategies for the triage and initial guideline-directed management of patients with a suspected irAE.

Learning Objectives

  • Evaluate patients for potential irAE development in non-oncology settings.
  • As part of a multidisciplinary care team, implement practice setting specific strategies for the triage and initial management of patients with a suspected irAE.

Financial Support

Supported by an educational grant from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

Target Audience

Pharmacists in outpatient, ambulatory, or community care settings.

Credit Information

Jointly Accredited Provider

In support of improving patient care, CME Outfitters, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Pharmacists (ACPE) 1.0

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit.
Activity UAN: JA0007185-0000-23-024-H01-P

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process.

Dr. Reynolds reports the following financial relationships:

Research Support: Project Data Sphere (a non-profit company)

Stock Shareholder (ownership interest): Biogen

Other Financial or Material Support: Teledoc Health, Inc.

Dr.Castner reports no financial relationships to disclose.

Dr. Dougan reports the following financial relationships:

Advisory Board: Cerberus Therapeutics and Veravas, Inc.

Consultant: Aditum Bio; Asher Biotherapeutics, Inc.; AzurRx BioPharma, Inc.; Eli Lilly and Company; Foghorn Therapeutics; Genentech, Inc.; Generate Biomedicines; Mallinckrodt Pharmaceuticals; Moderna, Inc.; ORIC Pharmaceuticals, Inc.; Palleon Pharmaceuticals; Partner Therapeutics, Inc.; Sorriso Pharmaceuticals; and SQZ Biotechnologies Company

Research Support: Eli Lilly and Company

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report:

  • Elizabeth Naber, MSN, RN, CCRN-K, CNRN, TCRN (peer reviewer)
  • Thomas Mitchell (planning committee)
  • Kasey Brandt, PharmD (planning committee)
  • David Modrak, PhD (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credit

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Call us at 877.CME.PROS (877.263.7767).


Time is of the Essence: Avoiding Delays in Identification and Management of irAEs
Event Date: 05/16/2023 at 4:00 am EST