Background: The indications of immune checkpoint inhibitors (ICIs) have expanded to both the palliative and curative cancer therapy settings. The goal of management for immune-related adverse events (irAEs) is to reduce the morbidity and mortality caused by irAE as well as to ensure efficacy of ICIs. The aim of KASCC/JASCC Joint Symposium is to discuss on the roles of supportive care in the management of irAEs.
Strategies and infrastructure for irAEs management:Firstly, we will summarize basic knowledge on irAEs from organ agnostic aspects, in terms of clinicopathological feature, baseline screening and routine monitoring of laboratory data, how to use steroid and immunosuppressive agents, and subsequent cancer treatment upon resolution of irAEs. We will learn organ-specific management for each irAE through case presentations, which is helpful to imagine practical management for irAE. After comprehensive overview of irAEs, we will discuss the essential components of irAE management infrastructure, including educational materials for patients and medical staffs, communication devices between medical staff and patients, or some hotline system. This infrastructure should aim to facilitate prompt recognition and reporting of irAEs, ensuring swift management actions. The approach to managing irAEs may vary internationally, influenced by differences in medical insurance coverage and other socioeconomic factors.
Roles of multidisciplinary collaboration: Because irAE can cause multi-organ events, supportive care against irAE should be performed in the multidisciplinary collaboration. We will be discussing on how and when to refer to organ-specific specialists if some irAEs occurred. It is also important for primary clinicians to increase their awareness of irAEs and collaborate with organ specific specialists from an early stage. Thus, the network between oncology care team and organ specific specialists should be build.
Future directions: Through this symposium, we will be able to recognize what scientific evidence is currently available and what is missing in the irAEs management. We may propose several suggestions in supportive care in the irAEs management. The first is a possibility of clinical trial to establish evidence-based algorisms for irAE management. Second is a possibility of international collaboration between Korea and Japan in this research field.

Aims: This symposium aims to integrate and share best practices in oncology care for patients with advanced cancer experiencing cancer cachexia and undergoing chemotherapy or palliative/supportive care.
Chairs: Egidio Del Fabbro (Palliative Medicine, Medical College of Georgia, Augusta University) and Koji Amano (Department of Supportive and Palliative Care, Osaka International Cancer Institute).
Session Summary: This session addresses the multifaceted challenges of cancer cachexia. It will explore the risk of cachexia development in lung cancer patients from the initial visit to treatment start, emphasizing early intervention strategies. Furthermore, the importance of multimodal treatment approaches in cancer cachexia care will be discussed. An analysis of how cancer types impact the results of nutrition and exercise treatment will be presented. High symptom burden, which impacts nutrition intake and exacerbates weight loss, muscle wasting and poor physical performance, will also be addressed. The session will highlight that oncology patients with weight loss often consume insufficient calories and protein for weight maintenance and that non-pharmacologic interventions such as nutritional counseling combined with medications for nutrition impact symptoms, may improve oral intake, quality of life and stabilize weight loss.

Speakers & Presentations:

Utae Katsushima, MD (Department of Thoracic Oncology, Kansai Medical University): "Cachexia at risk in lung cancer from the first visit to the start of treatment"
Yusuke Tachibana, MD (Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine): "What is required in cancer cachexia care? - Multimodal treatment could be a solution"
Shuichi Mitsunaga, MD (Division of Biomarker Discovery, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center ): "The spectrum according to cancer types affects the results of nutrition and exercise treatment in an ancillary analysis from the NEXTAC-TWO trial"
Egidio Del Fabbro, MD (Palliative Medicine, Medical College of Georgia, Augusta University): "Cachexia and Nutrition Impact Symptoms". Session Organizers: JASCC Cachexia Study group, Chair: Tateaki Naito (Shizuoka Cancer Center) and MASCC Nutrition & Cachexia Study group, Chair: Egidio Del Fabbro (Medical College of Georgia, Augusta University).
Session Organizers: JASCC Cachexia Study group, Chair: Tateaki Naito (Shizuoka Cancer Center) and MASCC Nutrition & Cachexia Study group, Chair: Egidio Del Fabbro (Medical College of Georgia, Augusta University).