From Evidence to Practice: Integrating Toripalimab into Frontline Care for Recurrent Locally Advanced or Metastatic Nasopharyngeal Carcinoma - Episode 6
Clinical Perspectives on Toripalimab in Practice
Panelists discuss the critical role of patient education and vigilant monitoring to manage immune-related toxicities during treatment, emphasizing the challenges of distinguishing the adverse effects from chemotherapy from immunotherapy, strategies for safely adjusting therapies, and the continued importance of radiation in select cases to enhance outcomes.
Patient education plays a crucial role in managing immune-related toxicities during treatment. Monitoring patients involves actively asking about symptoms such as diarrhea, shortness of breath, and heart issues. Diarrhea is a particular concern because it can indicate colitis, which may require prompt intervention with steroids and temporary treatment pauses. Skin rashes and liver function abnormalities are also commonly observed immune-related side adverse effects. Fortunately, these side adverse effects usually respond well to steroid treatment, and immunotherapy can often be safely resumed afterward to maintain its therapeutic effect.
Differentiating between toxicities caused by chemotherapy and those from immunotherapy can be challenging, especially when hematologic abnormalities arise. For example, thrombocytopenia might be related to chemotherapy agents like such as gemcitabine or could represent immune-related adverse effects. In such cases, a thorough workup is necessary, and temporarily withholding all treatment components may be prudent until the cause is clear. Sometimes, patients can continue treatment with platinum agents and immunotherapy while discontinuing gemcitabine to mitigate toxicity.
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