The following is a summary of “Assessment of Symptoms and Adverse Events Related to Immunotherapy in Patients With Cancer: An Integrative Review,” published in the JULY 2023 issue of Pain Management by AlQuzi, et al.
Clinical practice guidelines emphasized the importance of regularly assessing symptoms and adverse events in patients receiving immunotherapy for cancer. However, there was limited evidence on how such assessments are conducted outside of clinical trial settings. For a study, researchers sought to identify, evaluate, and synthesize the existing literature on assessing immune-related symptoms and adverse events in patients with cancer receiving immunotherapy outside of clinical trials. Specifically, they aimed to identify the measurement instruments used, who complete the assessments, and when they are conducted.
The review followed established methods and included a systematic literature search of electronic databases. A dual screening, quality appraisal, and data extraction process was performed. The review included primary studies (retrospective or prospective) that reported the use of instruments or strategies to assess symptoms or adverse events in patients with cancer undergoing immunotherapy. The outcomes of interest included the assessment methods used, types of assessment instruments, frequency and mode of administration, duration, and intensity of symptoms and adverse events, and associated management strategies. The data were synthesized narratively.
A total of 16 articles, representing 2,553 patients with cancer undergoing immunotherapy, were included in the review. All articles were published between 2018 and 2022 and demonstrated sound methodological quality. Seven studies were retrospective chart reviews, while the remaining studies prospectively collected data, with seven of them including patient-reported outcomes. Among studies that collected data at multiple time points, weekly assessments during immunotherapy were the most common frequency. Only four studies discussed the potential implementation of assessment into routine clinical practice.
Despite recommendations for routine assessment of symptoms and adverse events during immunotherapy for cancer, there is a lack of examples demonstrating how this is implemented in clinical practice. Using patient-reported outcome measures to assess immunotherapy toxicity is uncommon but holds potential for early identification of symptoms and timely intervention. The study highlighted the available assessment instruments and the need for further research to optimize patient outcomes in the field.
Source: jpsmjournal.com/article/S0885-3924(23)00396-2/fulltext
