Educating the cancer patient about the immunotherapy toxicity: a descriptive observational study

Immunotherapy can cause immune-related adverse events. Recognizing and communicating these symptoms is important for the patient to allow nurses to manage them promptly, avoiding complications or interruptions in therapy.

We conducted an observational study with the objective of creating a readable tool to be shared with patients to provide information on immune-related adverse events and provide clinical guidance to prevent and manage symptoms. Secondary objective was to determine the acceptability of the tool through a questionnaire developed ad hoc.

For each patient, data were collected such as: sex, age, educational qualification, marital status, area of residence, diagnosis, comorbidities, therapy, performance status. The information tool and a questionnaire were administered with the aim of evaluating its acceptability and feasibility.

35 patients were enrolled (mean age 65 years, standard deviation 10.7). The drugs used are: Pembrolizumab, Nivolumab, Atezolizumab, Durvalumab. A preliminary analysis of the data revealed a poor knowledge of immune-related adverse events (skin rash, thyroid disorders, pneumonia, gastrointestinal disorders, fatigue). All patients find the educational tool useful and easy to understand for recognizing and managing symptoms of therapy. The format of the tool was also appreciated.

Patient education is of fundamental importance to ensure early identification of immune-related adverse events, to avoid severe grades of toxicity and therapy interruptions, also causing a poor patient quality of life.

The nurse has a fundamental role in educating the patient about possible immune related adverse events and training courses are also needed in collaboration with oncologists.