Emerging Therapies Prompt Nuanced AE Management in Kidney Cancer

Emerging therapies for the treatment of patients with kideny cancer have changed management strategies for adverse effects (AEs), according to Kiran Virdee, RN, BSN, CCRN-K.

“[Although] it is important to provide patient education on [AE] management, it is also imperative to factor individual patient challenges [when assessing quality of life changes],” Virdee, a registered nurse at Memorial Sloan Kettering Cancer Center, said during a presentation titled “Daily Aspects of Side Effect Management” focusing in on kidney cancer treatments, during the 2022 International Kidney Cancer Symposium.

As part of her presentation, Virdee noted which physical manifestations of AEs have been linked to certain classes of drugs her clinical practice. For instance, for patients receiving tyrosine kinase inhibitor therapy, the common AEs have included hypertension, diarrhea, dermatitis, mucositis, fatigue, and nausea. With immunotherapy, the most common AEs have been colitis, dermatitis, pruritis, pneumonitis, endocrinopathies, and myocarditis. For radiotherapy, fatigue, pancytopenia, dermatitis, edema, and nausea, are the most frequently observed AEs, and with surgery, the main AEs have included pain, wound care, and fatigue.

She noted that the following list is not comprehensive but has found in her clinical experience that hypertension, diarrhea, dermatitis, mucositis, fatigue, and decreased appetite tend to be the AEs patients experience the most difficulty with day to day. Therefore, she outlined some key strategies in helping patients mitigate these daily toxicities.

Hypertension

For patients experiencing hypertension, Virdee recommends conducting routine and accurate blood pressure reading and keeping a daily log of patient blood pressure.

Diarrhea

Virdee stressed the importance of recording baseline bowel movements to gauge the extent to which diarrhea is affecting patients during treatments. For patients who experience diarrhea, diet modifications, routine stool sample collections, and antidiarrheal medication are all key aspects of management.

Dermatitis

Dermatitis also affects many patients. Strategies to manage dermatitis include daily skin checks, emollient based creams, topical steroids, and consultations with a dermatologist.

Mucositis

A review of a patient’s mouth care routine may be needed if they are experiencing mucositis. Steroid rinses and diet modifications are useful for AE management.

Source:

https://www2.onclive.com/view/emerging-therapies-prompt-nuanced-ae-management-in-kidney-cancer