Nursing ECHO Case Presentations-Immunotherapy Toxicities

Video Transcription

Video Summary

This session discussed the case of a 43-year-old woman with PDL1-positive cervical cancer, treated with induction chemotherapy, pembrolizumab, and concurrent chemoradiation. A year into pembrolizumab, she developed severe joint pain and stiffness affecting daily activities, suspected to be immunotherapy-induced inflammatory arthritis rather than menopausal symptoms from treatment-induced menopause. The multidisciplinary team emphasized comprehensive patient assessment using tools like distress thermometers and CTCAE adverse event scales, alongside evaluation by menopause specialists and rheumatologists. Management involved short courses of steroids, treatment breaks, NSAIDs, and physiotherapy, with considerations for dose adjustment of pembrolizumab if symptoms worsened. The discussion highlighted challenges including differentiating treatment side effects from menopause symptoms, access to specialized supportive services, and the importance of multidisciplinary collaboration. Participants shared different institutional practices regarding symptom assessment tools and handling of treatment-induced menopause, also noting shortages of hormone replacement therapy patches impacting symptom management. The session underscored the value of proactive nursing follow-up, patient education, and building trust to facilitate reporting of side effects. The moderators encouraged ongoing knowledge exchange through future Nursing Echo sessions, aiming to enhance global nursing practices in gynecologic oncology care. Resources such as the British Gyne Cancer Society guidelines and the Keynote 826 trial were recommended for further learning.

Asset Subtitle

Recorded on January 17, 2025

Keywords

PDL1-positive cervical cancer

pembrolizumab

immunotherapy-induced inflammatory arthritis

treatment-induced menopause

multidisciplinary team

symptom assessment tools

steroid therapy

nursing follow-up