Quality Assessment of an Immunotherapy Toxicity Clinic: A Clinical Audit at Castle Hill Hospital Evaluating Adherence to Clinical Guidelines, Documentation Standards, and Clinical Outcomes

Immunotherapy has developed as a cancer treatment by enhancing the body's immune system to attack cancer cells. Checkpoint inhibitors (e.g., programmed cell death protein-1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte antigen-4 (CTLA-4)) have shown very good outcomes in treating several tumour types. However, their use can cause a unique category of toxicities, immune-related adverse events (irAEs). These differ from chemotherapy-related side effects, may affect any organ, and require specialised recognition and management. This audit reviews the performance of a dedicated Immunotherapy Toxicity Clinic at Queen’s Centre for Oncology and Haematology, Hull University Teaching Hospitals. It includes all oncology patients referred between January 1 and June 30, 2024. Using a validated clinical tool, we assess the types, severity, and outcomes of irAEs, as well as adherence to protocols and quality of documentation. This work highlights current practice, identifies gaps, and provides a quality improvement tool for managing patients on immunotherapy.