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Side-Effects Management

The NCCN’s first guideline for side effects from immunotherapy recognizes a new spectrum of events in patients who are receiving immune checkpoint inhibitor therapy.

Based on research presented at the 2018 National Comprehensive Cancer Network Annual Conference, patients weighing 60 kg to 85 kg who often receive lower-than-recommended doses of filgrastim, without evidence of its noninferiority to recommended doses, is found to be not only acceptable, but also cost-saving.

At the 2018 Cancer Survivorship Symposium, Katy K. Tsai, MD, suggested that cancer treatment with immunotherapy warrants special consideration from a survivorship standpoint because of its novel mechanisms of action, extended treatment periods, and unique toxicities.

Interim data from a recent clinical trial of nelipepimut-S plus trastuzumab showed a disease-free survival advantage compared with trastuzumab alone in patients with HER2 1+/2+ breast cancer.

“There’s a human behind the patient, and he can tell us what he needs. He’s really the expert in the field,” Christine B. Boers-Doets, MSc, Netherlands Leiden University Medical Center, told attendees at the recent ESMO International Consensus Conference for Advanced Breast Cancer.

Immunotherapy is a hot topic in oncology, with hundreds of ongoing clinical trials. As more patients are treated with checkpoint inhibitors, nurses will play a key role in the management of these patients.
The incidence of human papillomavirus (HPV)-associated oropharyngeal cancer is increasing. Patients treated for these cancers with radiation and chemotherapy are at increased risk for early and late side effects that diminish their quality of life, and nurses play a key role in coaching patients about living with these side effects.
Real-world experience at The University of Texas MD. Anderson Cancer Center, Houston, showed that the most frequent immune-related adverse events leading to emergency department visits for patients treated with immune checkpoint inhibitors were diarrhea, colitis, pneumonitis, and dermatitis.
The current practice in the treatment of advanced kidney cancer and some other cancers is to continue treatment with immune checkpoint inhibitors until disease progression, and sometimes even longer.
The results of a new study presented at the 2017 Genitourinary Cancers Symposium suggest that recent use of antibiotics may compromise the efficacy of immunotherapy.
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