Dr Postow on an Ideal Post-ICI Monitoring Framework in Melanoma

“Once someone finishes treatment with a checkpoint inhibitor, they’re usually continuing surveillance with the medical oncologist that delivered the immune checkpoint inhibitor. That relationship with the oncologist is important to maintain, [especially] in the immediate aftermath of discontinuing a checkpoint inhibitor.”

Michael A. Postow, MD, chief of the Melanoma Service at Memorial Sloan Kettering Cancer Center, discussed the importance of long-term multidisciplinary follow-up for patients with melanoma treated with immune checkpoint inhibitors (ICIs).

After patients complete immunotherapy and transition into surveillance, ongoing relationships with oncology teams and subspecialists remain essential for identifying and managing delayed or chronic toxicities that may persist well beyond treatment discontinuation, Postow explained.

Following the completion of immunotherapy, most patients continue regular follow-up with the medical oncologist who administered their treatment, Postow said. These visits are often centered around routine cancer surveillance using imaging modalities such as CT scans, PET scans, or MRIs to monitor for disease recurrence or progression. However, surveillance appointments also provide critical opportunities to identify evolving symptoms that may reflect late-onset immune-related complications.

Even when patients are no longer actively receiving immunotherapy, new symptoms such as fatigue, skin changes, endocrine dysfunction, or musculoskeletal complaints may represent delayed or chronic immune-mediated toxicities. Careful symptom assessment and ongoing communication remain necessary because these adverse effects (AEs) can emerge gradually and persist for extended periods, Postow stated.

Additionally, some patients may require involvement from additional specialists to manage organ-specific toxicities that develop during or after ICI treatment. Endocrinologists may help address long-term hormone deficiencies resulting from immune-mediated endocrine dysfunction, while dermatologists often play a key role in managing persistent skin toxicities. Similarly, rheumatologists may become integral members of the care team for patients experiencing chronic inflammatory arthritis or other autoimmune joint complications.

As patients move farther from active cancer treatment, the frequency of oncology visits may naturally decrease, reflecting stable disease status and routine surveillance intervals. Nevertheless, subspecialty care often continues long term, as some immune-related AEs may become chronic conditions requiring sustained management. Maintaining these specialist relationships is viewed as essential for preserving patient quality of life and functional well-being.

Overall, survivorship after treatment with ICIs extends beyond cancer surveillance alone, Postow reiterated. Effective long-term care requires continued coordination among oncologists and multidisciplinary specialists to monitor, diagnose, and manage persistent immune-related toxicities. These collaborative care relationships are critical to supporting patients throughout survivorship and ensuring the best possible long-term outcomes following immunotherapy treatment, Postow concluded.