Document Type : Review Articles
Authors
1
First Health Cluster, Ministry of Health, Saudi Arabia
2
Al-Yamamah Health Center in Al-Kharj, the first health cluster, Ministry of Health, Saudi Arabia
3
Al-Kharj, the first health cluster, Ministry of Health, Saudi Arabia
4
King Khalid Hospital, Ministry of Health, Saudi Arabia
5
Riyadh First Health Cluster, Ministry of Health, Saudi Arabia
6
King Salman Hospital, the First Health Cluster in Riyadh, Ministry of Health, Saudi Arabia
7
Aljazerah primary health care center, Ministry of Health, Saudi Arabia
8
Dhahrat Al Badia Health Care Center, Ministry of Health, Saudi Arabia
9
Al-Jouf Gathering, Ministry of Health, Saudi Arabia
10
Al Eman general hospital, Ministry of Health, Saudi Arabia
11
Second health Cluster, Ministry of Health, Saudi Arabia
12
Nursing, Ministry of Health, Saudi Arabia
Abstract
Introduction: Immunotherapy, particularly immune checkpoint inhibitors (ICIs), has become a groundbreaking approach in cancer treatment. This includes therapies targeting the PD-1/PD-L1 and CTLA-4 pathways to enhance the immune system’s ability to recognize and attack cancer cells. Several cancers, including melanoma, lung, kidney, and colorectal cancer, are treated using ICIs. However, despite their efficacy, ICIs are associated with immune-related adverse events (irAEs) that can range from mild to life-threatening, affecting various body systems such as the skin, gastrointestinal tract, liver, and endocrine organs.
Aim: This article explores the biochemistry of immune checkpoint inhibitors, their mechanisms of action, the impact of irAEs, and the crucial role of nursing in managing these adverse events. It emphasizes the need for nurses to monitor, educate, and intervene to mitigate the risks associated with ICIs, ensuring better patient outcomes during cancer treatment.
Methods: A comprehensive review of current literature, clinical guidelines, and case studies on the mechanisms, types, and management of irAEs related to ICIs was conducted. The review also covers the nursing interventions necessary for the early detection, management, and education of patients receiving immunotherapy.
Results: Immune checkpoint inhibitors work by disrupting the immune system’s negative regulation, restoring the body's immune response against tumors. However, irAEs occur as a result of this enhanced immune response, leading to systemic inflammation that can damage healthy organs. Nurses play a critical role in identifying early signs of irAEs, educating patients on symptoms, and coordinating care to minimize these effects. Nursing protocols include monitoring patients for signs of toxicity, providing symptom management, and educating patients on reporting adverse symptoms, even those occurring long after treatment cessation.
Conclusion: While ICIs have revolutionized cancer treatment, their associated irAEs require vigilant monitoring and management. Nurses are at the forefront of ensuring safe and effective cancer care through early detection, prompt intervention, and continuous patient education. Integrating these practices into routine clinical care can improve patient outcomes, reducing the severity of irAEs and enhancing the therapeutic benefits of ICIs.
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