I work at a practice that has adopted OCM guidelines and therefore, we, too, are required to complete survivorship plans. As mentioned above, Stage IV patients are exempt. This is certainly a reflection on the fact that we historically have had few durable responses in patients with Stage IV cancer (melanoma among other tumor types), but as we know, IO has changed the face of melanoma and other cancers. That being said, we are completing survivorship plans for patients with other stages. I do believe that we are going to see more a more late immune-mediated adverse events that occur as we follow these patients longer and longer. Also, as previously mentioned in another post, fertility issues/safe childbearing, etc. is going to be another major topic in survivorship with our young patients, as we really have no data about how these drugs could impact a pregnancy after the mother has completed therapy and drug is presumably washed out. We know, from experience, that the immune system can continue to be upregulated for a durable amount of time.

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