Imagine this scenario. You are working in a busy Accident and Emergency department on a Saturday afternoon. A 45-year-old male patient, Mr. Johnson, who is undergoing treatment for metastatic melanoma, has attended with diarrhoea and abdominal pain. His family mentioned he had started a new cancer treatment in the last few months, but the details are sparse. The initial assessment by the A&E team has not flagged anything unusual beyond gastroenteritis.
What are your initial thoughts? What might be causing his symptoms?
On further investigation, Mr. Johnson is undergoing cancer treatment with nivolumab and ipilimumab.
It is likely that he is experiencing an immune-related adverse event (irAE), a common but often misunderstood complication of immune checkpoint inhibitors (ICIs), a type of immunotherapy.
How did you do? Did you think of an immune-related adverse event?
If you didn’t think of an immune-related adverse event, you are not alone. A 2023 survey of oncology doctors, nurses and pharmacists found significant knowledge gaps in immune checkpoint inhibitors and immune-related adverse events. For example, only 59% of respondents were able to correctly select irAEs from a multiple-choice list, and 50% were able to correctly identify which steroids are used in the management of acute irAEs.
Additionally, only 49% and 42% of respondents correctly answered case-based scenario questions on gastrointestinal and skin toxicities respectively.
The results highlight the need for targeted education in this area, covering the foundational science of ICIs and ensuring correct resource use for acute irAE identification and management.
The Crucial Role of Awareness
Immunotherapy has revolutionised cancer treatment, offering hope where traditional therapies have failed. Cancer cells can switch off the immune system to prevent destruction. Drugs such as immune checkpoint inhibitors can keep the immune system active to attack cancer cells, leading to significant improvements in survival rates for many patients. However, these therapies come with a unique set of potential side effects, known as immune-related adverse events (irAEs).
irAEs can affect any organ system, manifesting as colitis, pneumonitis, hepatitis, endocrinopathies, and more. These side effects often mimic other common conditions, making diagnosis challenging. Quick, accurate assessments are critical: healthcare professionals’ ability to recognise that a patient is on an immune checkpoint inhibitor and connect their symptoms to irAEs can significantly impact patient outcomes.
Recognising the Signs
For Mr. Johnson, his symptoms were not merely gastroenteritis; they were a sign of severe colitis induced by his immunotherapy. The key to managing such cases lies in timely and accurate identification of the underlying cause. This requires healthcare professionals across all specialties to be vigilant and informed about the potential for irAEs in patients undergoing certain immunotherapies.
Why Recognition and Management Matter
Failure to promptly recognise and treat irAEs can lead to serious, even life-threatening complications. Conversely, early detection and appropriate management can mitigate these risks, ensuring better patient outcomes. For healthcare professionals, including those in A&E or primary care settings, understanding irAEs is crucial. Optimal and timely intervention make a critical difference for patients like Mr. Johnson.
A Call to Action
To bridge this knowledge gap, we are excited to announce an upcoming eLearning course focused on immune-related adverse events. These comprehensive microlearning modules will equip healthcare professionals with the essential knowledge to identify, assess, and manage irAEs effectively.
What You Will Learn
Understanding Immune Checkpoint Inhibitors: An overview of how these treatments work and how they can cause irAEs.
Recognising irAEs: Key signs and symptoms to watch for across different organ systems.
Management Strategies: Best practices for investigating and managing acute irAEs, ensuring correct use of guidelines and resources.
Interactive Case Studies: Real-world examples and lessons learned from managing irAEs in various clinical settings.
Why It Matters
By enhancing your understanding of irAEs, you will be better prepared to provide high-quality care for cancer patients undergoing treatment with immune checkpoint inhibitors. This knowledge not only improves patient safety but also ensures that these treatments can continue to be used effectively and safely.
Enroll Today
Stay ahead in your practice and ensure the best outcomes for your patients. Enroll in our e-learning course on immune-related adverse events and become a key player in the multidisciplinary approach required for managing these complex cases. Your expertise can save lives.
Use the links below to access the e-learning.
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