Toxicity Management: Development of a Novel and Immune-Mediated Adverse Events Algorithm

Clin J Oncol Nurs. 2017 Apr 1;21(2 Suppl):53-59. doi: 10.1188/17.CJON.S2.53-59.

Abstract

Background: Novel immunotherapy and biologic agents are being developed with the potential to improve outcomes and reduce long-term toxicities among individuals with hematologic malignancies. These emerging drugs affect neoplastic cells and the surrounding microenvironment, causing unique immune-mediated toxicities. .

Objectives: The aim was to develop an algorithm for clinical staff to manage unique toxicities associated with next-generation immunotherapies indicated in the hematologic population, using a system-focused approach. .

Methods: Data were collected using specific toxicities based on the four major novel biologic classes. Immune-mediated adverse events were reported across studies. Based on published literature, institutional experience, and group consensus, a novel algorithm for managing immune-mediated toxicities was created. .

Findings: The development of this treatment algorithm provides a more streamlined approach for managing common but unique toxicities and improves safety, compliance, patient outcome, and quality of life with novel immuno-oncologic agents.

Keywords: adverse events; immune-mediated; immunotherapy; novel agents; toxicities.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Antibodies, Monoclonal / toxicity*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / nursing*
  • Education, Nursing, Continuing
  • Female
  • Hematologic Neoplasms / drug therapy*
  • Hematologic Neoplasms / immunology*
  • Hematologic Neoplasms / nursing
  • Humans
  • Immunotherapy / adverse effects*
  • Immunotherapy / nursing*
  • Male
  • Middle Aged
  • Oncology Nursing / standards*
  • Practice Guidelines as Topic

Substances

  • Antibodies, Monoclonal