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Original Article
Year: 2021 I Volume: 3 I Issue: 1I Pages I 1-5

Multidisciplinary approach for improvement of immunotherapy utilization in solid tumors with H MSI /dMMR –An action plan from a single oncology center

Nagwa Ibrahim 1, Muneerah Alzouman 2, Abdulaziz Alhamad 3, Muneera AlMajed 3, Mohamed Almeziny 1, Huda Aldossary 1, Bander Alharbi 1, Sumliman AlRashed 4 

1Prince Sultan Military Medical City, Department of Pharmaceutical Services, Riyadh, Saudi Arabia

2 Prince Sultan Military Medical City, Central Laboratory Department, Riyadh, Saudi Arabia

3 Prince Sultan Military Medical City, Adult Oncology Department, Riyadh, Saudi Arabia

4 Medical Services Department, Armed Forces, Riyadh, Saudi Arabia

* Corresponding Author:

Nagwa Ibrahim, Pharm D, PhD

Email address: 

Source of funding:  None


Conflict of interest: None

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Key wards: immunotherapy, MSI-H, dMMR, soild tumors, oncology, multidisciplinary approach, action plan


Immune checkpoint inhibitors such as nivolumab and pembrolizumab are approved by Food and Drug Administration for patients diagnosed with metastatic solid tumors with high microsatellite instability (MSI) or mismatch repair deficient (dMMR). The prognosis of these patients is generally poor, that is why it is very essential to identify the targeted patients who can benefit from immunotherapy. Pembrolizumab is approved in our institution for this indication. In order to ensure proper utilization of available resources, we decided to make a pilot retrospective review to evaluate pembrolizumab utilization, to identify the problems we are facing then to set an action plan through multidisciplinary approach. Based on the results we set recommendations. This paper is innovative and the first in kind. It could be used as guidance for other centers using immunotherapy and could be applied for other drugs as well to ensure best practice, patient safety and maximize utilization of resources.   


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