The landscape of cancer care has undergone a dramatic shift, due to the availability and increased use of immunotherapy agents such as immune checkpoint inhibitors (ICIs). As more patients become eligible to receive ICIs, clinicians need to be able to recognize immune-mediated adverse events (irAEs) and remain informed about the most up-to-date strategies for managing these toxicities.

As these therapies continue to evolve, it is imperative that nursing policies are created/revised and shared with nursing staff to remain up to date on current clinical practice for these complications. With continued education and reinforcement of protocols, nurses can positively impact patient outcomes.

Oncology pharmacists are vital members of the oncology team with specialized knowledge of anticancer therapy and can help navigate therapeutic interventions, contributing to selection, dosing, monitoring, evaluation, and education of medications to improve oral immune-related adverse event outcomes.

Continuing education on the importance of early recognition and management of immunotherapy-related toxicities and involvement of the multidisciplinary team will be crucial to ensure optimal outcomes for patients with cancer.

Oncology pharmacists are vital members of the oncology team with specialized knowledge of anticancer therapy and can help navigate therapeutic interventions, contributing to selection, dosing, monitoring, evaluation, and education of medications to improve oral immune-related adverse event outcomes.

These NCCN Guidelines Insights highlight recent guideline updates pertaining to the management of emerging toxicities related to cancer immunotherapy.

While cytokine release syndrome and neurotoxicity are widely reported as the most common acute CAR T-cell toxicities, it is essential for providers to understand that CAR T-cell therapy may also result in other toxicities (such as infections, cytopenias, or B-cell aplasia), some of which could persist for months to years after infusion.

As the field of cancer immunotherapy continues to evolve, clinicians need to be informed about the most up-to-date strategies for managing immunotherapy-related toxicities. Providing continuing education on early recognition and effective management of immunotherapy-related toxicities is crucial to ensure optimal outcomes for an increasing number of patients treated with immunotherapy.

Education on this topic will enable clinicians to more rapidly identify when they may need to seek the expertise of disease specialists, and which specialists may be most relevant to their patients’ needs.

CAR T-cell products have the ability to completely change the treatment paradigm for hematologic malignancies.  These therapies are associated with life-threatening toxicities that require rapid intervention. Newly published consensus statements to better define and grade these toxicities should be incorporated into clinical practice.