Postow, M.A. (2015). Managing immune checkpoint-blocking antibody side effects. American Society of Clinical Oncology 2015 Educational Book, 76–83. 

DOI Link

Purpose & Patient Population

PURPOSE: To describe the side-effect profile and discuss treatment strategies to manage immune-related adverse events associated with newer agents
 
TYPES OF PATIENTS ADDRESSED: Cancer patients diagnosed with melanoma

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Expert opinion

 

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Elder care

Results Provided in the Reference

Unable to discern any information about scope or evidence used in this article. Expert opinion.

Guidelines & Recommendations

Recommendations for the management of mild diarrhea include oral hydration, American Dietary Association diet, and lomotil four times per day. For symptoms that persist for more than three days or increase, oral or IV corticosteroids should be used, although no dosages were noted. For severe cases in which steroids do not improve diarrhea, patients should be hospitalized for IV therapy to include hydration and steroids up to 2 mg/kg twice a day. For symptoms that still persist, infliximab 5 mg/kg once every two weeks can be used.

Limitations

  • Limited clinical experience with immune checkpoint inhibitors
  • Only patients with melanoma were considered.

Nursing Implications

Additional studies need to be conducted to determine the best management practice for gastrointestinal side-effect management with immune-checkpoint blocking antibodies in a variety of cancer types.