Hi Virginia,
Regarding your adjuvant patient who is experiencing ongoing colitis despite 3 doses of infliximab,vedolizumab would have been a good next step consideration, unfortunately, this is not an option. Just a thought, could the patient be treated on a routine “colitis” regimen with maintenance dosing rather than episodic dosing until sx are under long term control. Thoughts?

HI Yael,
You are so correct that although each clinical provider on the team is responsible for understanding, educating and assessing immune related adverse events ( irAE’s), it is more often nurses who are the point person for education. Educational encounters occur at the beginning of treatment, during treatment and ongoing support after treatment. The types of adverse events covered in educational sessions are the ones that are found in the prescrbing information for immunotherapies:
We commonly start with the most prevalent, Derm & GI, then discussing less common irAE’s but ones that could become clinically significant if not identified & intervened with, which are Endocrine, Pulmonary, Renal, Hepatotoxicity, Neuropathy/ other Neurologic changes, ocular toxicity. We always keep in mind that ANY organ system can be impacted but we know that the above listed organ systems are the ones recommended that we oversee closely for patients who are or have been tretated with an immuontherapy.

For additional supportive resources please visit the Home page of immunotherapy.wpengine.com, there are downloadable & printable materials, that can serve as a guide when you are reviewing irAE’s with a patient. Visiting the product / drug homepages and prescribing information is always recommended to keep abreast of any updates or changes.

thank you so much for your inquiry, I hope it is helpful to you!