Immune Checkpoint Inhibitor-Related Adrenal Insufficiency

Abstract

Objective: It is an exciting time in oncology nursing as new treatments are continually emerging to improve oncological outcomes for people affected by cancer. Immunotherapy is one such innovation in contemporary oncology practice, but the side effects of its treatment can be life threatening. Oncology nurses must be educated in the early identification of life-threatening side effects, and deliver evidence-based interventions to manage consequences of therapy such as, immune checkpoint inhibitor-related adrenal insufficiency.

Data source: This article utilizes a case study to emphasize the need for early identification and interventions for clinical management of immunotherapy related adrenal insufficiency. A review of the current evidence is included to provide recommendations for oncology nurses who are involved in providing care for people affected by cancer receiving immunotherapy.

Implications for nursing practice: Oncology nurses are the frontline caregivers to assess, recognize, so that early intervention and treament can lead to optimal patient outcomes.

Conclusion: Adrenal insufficiency is a life-threatening condition that is difficult to diagnose but if recognized early, morbidity can be prevented, quality of life improved, treatment initiated and life saving immunotherapy treatment can safely continue. Oncology nurses play an active role in ensuring the safe administration of immunotherapy by recognizing this important immune related adverse event. I would like to give credit to Patricia Jakel, RN, MSN, UCLA CNS and Dr. Melissa Lechner, UCLA endocrinologist for their invaluable input in this article.

Keywords: Case study; Clinical reflection; Evidence-cased; Immune Checkpoint Inhibitor-Related Adrenal Insufficiency; Oncology nurses.