Practical Tools for Managing Immunotherapy Toxicities with Care Step Pathways
This section provides links to individual Care Step Pathways, which are valuable tools to address toxicities associated with immunotherapy.
The Care-Step Pathways reflect the latest management strategies from ASCO, the NCCN, and the relevant drug manufacturer for immune-related adverse event grading and management. The sections provide information about assessment, grading, and management in a colorful and easy-to-use format.
There are multiple sections in these documents:
- Assessment: The “Look, Listen, and Recognize” section guides oncology health care providers to a specific set of symptom-related questions to ask the patient and/or caregiver as well as additional information to consider as part of the clinical assessment.
- Grading Toxicity: The Common Terminology (or Toxicity) Criteria for Adverse Events (CTCAE) for grading is used to allow interpretation of subjective symptoms in an objective manner. These criteria employ a grading system—from 1 (mild) to 4 (life-threatening)—to represent that toxicity defined by specific parameters according to the organ system involved.
- Management: The section addressing management focuses on the practical, nurse-led interventions that health care providers undertake, as well as anticipatory guidance regarding drug holds/discontinuations, dosage adjustments, and other strategies.
- Red flags: Important reminders to intervene rapidly at the recognition of signs/symptoms of serious, life-threatening manifestations of adverse events.
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