Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results
Background: With the increasing use of immune checkpoint inhibitors (ICIs), immune-related adverse events (irAEs) have become more prevalent in oncological practice. Clinical approaches vary due to the exclusion of patients with comorbidities from trials and the lack of long-term data on irAEs. As i...
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Elsevier
2025-06-01
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| Series: | ESMO Real World Data and Digital Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949820125000360 |
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| author | M. Verhaert Y. Aydogan S. Aspeslagh |
| author_facet | M. Verhaert Y. Aydogan S. Aspeslagh |
| author_sort | M. Verhaert |
| collection | DOAJ |
| description | Background: With the increasing use of immune checkpoint inhibitors (ICIs), immune-related adverse events (irAEs) have become more prevalent in oncological practice. Clinical approaches vary due to the exclusion of patients with comorbidities from trials and the lack of long-term data on irAEs. As irAEs can affect any organ system, sometimes becoming life-threatening, and their immunosuppressive treatments may influence oncological outcomes, collaboration between oncologists and organ specialists familiar with autoimmune syndromes is essential. The goal is to share experiences, learn, and identify clinically relevant research questions. Methods: The Belgian multidisciplinary ImmunoTOXicity board (BITOX) is a virtual meeting for oncologists and organ specialists held biweekly (every two weeks). Health care providers submit questions about irAE diagnosis, management, and ICI safety in dysimmune patients through an electronic form. Dysimmunity is defined by the presence of autoimmune disease, solid organ transplantation, ongoing antiviral or antibiotic treatment, corticosteroid therapy, paraneoplastic syndrome, Eastern Cooperative Oncology Group (ECOG) performance status >2, pregnancy, or a history of irAE. This paper presents a retrospective, descriptive analysis of the cases discussed over the past 3 years. Results: Between March 2021 and March 2024, 246 clinical cases from 131 submitting physicians were discussed. The majority (n =142) concerned irAE management. Most patients were treated with anti-programmed cell death protein 1 monotherapy (n = 111; 45.1%) and had dysimmune comorbidities (n = 162; 65.9%). Neurological (n = 35; 14.2%) and rheumatological (n = 32; 13%) irAEs were the most frequently submitted. Conclusions: The establishment of a national, virtual, multidisciplinary immunotoxicity board in Belgium is feasible and highlights relevant future research questions. It enhances multidisciplinary discussion of ICI-related issues in Belgium. |
| format | Article |
| id | doaj-art-ce938fad8f26404cbc764572ec382149 |
| institution | OA Journals |
| issn | 2949-8201 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | ESMO Real World Data and Digital Oncology |
| spelling | doaj-art-ce938fad8f26404cbc764572ec3821492025-08-20T02:20:11ZengElsevierESMO Real World Data and Digital Oncology2949-82012025-06-01810014710.1016/j.esmorw.2025.100147Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and resultsM. Verhaert0Y. Aydogan1S. Aspeslagh2Department of Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, BelgiumDepartment of Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, BelgiumDepartment of Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; Department of Internal Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium; Correspondence to: Dr Sandrine Aspeslagh, Department of Medical Oncology and Internal Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium. Tel: +3224776040Background: With the increasing use of immune checkpoint inhibitors (ICIs), immune-related adverse events (irAEs) have become more prevalent in oncological practice. Clinical approaches vary due to the exclusion of patients with comorbidities from trials and the lack of long-term data on irAEs. As irAEs can affect any organ system, sometimes becoming life-threatening, and their immunosuppressive treatments may influence oncological outcomes, collaboration between oncologists and organ specialists familiar with autoimmune syndromes is essential. The goal is to share experiences, learn, and identify clinically relevant research questions. Methods: The Belgian multidisciplinary ImmunoTOXicity board (BITOX) is a virtual meeting for oncologists and organ specialists held biweekly (every two weeks). Health care providers submit questions about irAE diagnosis, management, and ICI safety in dysimmune patients through an electronic form. Dysimmunity is defined by the presence of autoimmune disease, solid organ transplantation, ongoing antiviral or antibiotic treatment, corticosteroid therapy, paraneoplastic syndrome, Eastern Cooperative Oncology Group (ECOG) performance status >2, pregnancy, or a history of irAE. This paper presents a retrospective, descriptive analysis of the cases discussed over the past 3 years. Results: Between March 2021 and March 2024, 246 clinical cases from 131 submitting physicians were discussed. The majority (n =142) concerned irAE management. Most patients were treated with anti-programmed cell death protein 1 monotherapy (n = 111; 45.1%) and had dysimmune comorbidities (n = 162; 65.9%). Neurological (n = 35; 14.2%) and rheumatological (n = 32; 13%) irAEs were the most frequently submitted. Conclusions: The establishment of a national, virtual, multidisciplinary immunotoxicity board in Belgium is feasible and highlights relevant future research questions. It enhances multidisciplinary discussion of ICI-related issues in Belgium.http://www.sciencedirect.com/science/article/pii/S2949820125000360immune checkpoint inhibitorsdrug-related side effects and adverse reactionsautoimmune diseasesmultidisciplinary care team |
| spellingShingle | M. Verhaert Y. Aydogan S. Aspeslagh Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results ESMO Real World Data and Digital Oncology immune checkpoint inhibitors drug-related side effects and adverse reactions autoimmune diseases multidisciplinary care team |
| title | Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results |
| title_full | Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results |
| title_fullStr | Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results |
| title_full_unstemmed | Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results |
| title_short | Three-year analysis of the Belgian multidisciplinary immunotoxicity (BITOX) board: organization, feasibility, and results |
| title_sort | three year analysis of the belgian multidisciplinary immunotoxicity bitox board organization feasibility and results |
| topic | immune checkpoint inhibitors drug-related side effects and adverse reactions autoimmune diseases multidisciplinary care team |
| url | http://www.sciencedirect.com/science/article/pii/S2949820125000360 |
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