Survivorship experience for patients (pts) with metastatic melanoma (MM) on immunotherapy (IT).

e21503 Background: IT has significantly improved survival for pts with MM. The experience of long-term responders remains under-studied. We characterised survivorship issues faced by these pts using a cross-sectional survey. Methods: Eligible pts had MM, aged ≥18, ≥ 6 months post initiation of IT, and attained an objective response or stable disease. A 72-item questionnaire including items from validated measures and customised questions covering physical and psychological effects, impact on lifestyle, access to information, satisfaction with care, and availability of supports was administered. The impact of duration on and off IT was assessed. Results: 69/78 (88%) pts [median age 63 (range: 24-88); 42 (61%) male; 10 (15%) with BRAF V600 mutation] responded from Aug-Dec 2017. 50 (72%) had stage IVC disease. 49 (71%) were on 1st line therapy. Pts received single agent anti-PD1 (50, 72%), combined anti-PD1 and anti-CTLA-4 (13, 19%) and anti-CTLA4 (6, 9%). 39 (56%) were still on treatment. Reasons for IT cessation were toxicity (63%) and sustained response following ≥ 24 months of therapy (36%). Long-term toxicity (41, 59%): dermatological (51, 74%), rheumatological (30, 58%) and fatigue (62, 91%) were common. Combined anti-CTLA4 and anti-PD-1 resulted in more long term toxicity compared with anti-PD-1 monotherapy. The prevalence and type of symptoms was similar for pts on IT ( < or > 12 months) and pts who were off IT. Psychological morbidity including anxiety awaiting results (50, 72%), fear of cancer recurrence (56, 81%) and fear of death (44, 64%) was common. Anxiety awaiting results reduced with duration of IT. However, concerns regarding long term toxicity increased. Concern about stopping IT was common (50, 85%). Many pts reported difficulties with domestic tasks (36, 52%) and recreational activities (43, 62%). Most valued a survivorship care plan (SCP) (63, 91%) and screening for other cancers (67, 97%). Conclusions: Understanding the issues faced by long-term responders is essential to optimise pt care. Pts may benefit from routine discussion regarding IT cessation and long term toxicities, tailored psychological support and a SCP.