Home anti-PD1 immunotherapy for melanoma: results of a patient and nursing satisfaction survey

Background: Immunotherapies have revolutionized the management of melanoma, particularly anti-PD1 agents. While the COVID-19 pandemic disrupted the organization of day hospital care, this health context motivated the implementation of home immunotherapy. Objectives: We evaluated the safety of home immunotherapy and the satisfaction of patients receiving anti-PD1 agents at home for melanoma. Materials & Methods: All patients with advanced melanoma, followed at Grenoble University Hospital between June 2020 and August 2021 and receiving a home infusion of anti-PD1 treatment, were included. A satisfaction questionnaire was distributed to patients and to physicians and nurses in charge of these patients. Results: Twenty-six patients were included. No serious adverse events occurred. Of these 26 patients, 25 (96%) were satisfied with their home care. The main strengths were time savings and reduced travel. The main potential issue, according to patients, was the nurses' lack of experience. The physicians (n=5) and private nurses (n=9) were also satisfied overall (100% and 44% respectively). The main issue for nurses was the lack of training in melanoma (78%). Conclusion: Home-based anti-PD1 immunotherapy for advanced melanoma is safe, well accepted and welcomed by patients and caregivers. One of the difficulties raised by homecare was the lack of training of private practice nurses in pathology, which underlines the importance of developing a care pathway.