Review Article

How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know

Marianne Davies, DNP, MSN, CNS, ACNP, AOCNP®

Yale University School of Nursing, Yale Cancer Center, New Haven, Connecticut

Author's disclosures of potential conflicts of interest are found at the end of this article.

Marianne Davies, DNP, MSN, CNS, ACNP, AOCNP®, Yale University School of Nursing, 400 West Campus Drive, PO Box 27399, West Haven, CT 06516. E-mail: marianne.davies@yale.edu


J Adv Pract Oncol 2016;7:498–509 | doi: 10.6004/jadpro.2016.7.5.3 | © 2016 Harborside Press®


  

ABSTRACT

Abstract

The immune system plays an active role in controlling and eradicating cancer. T cells, an essential component of the adaptive immune system, have a number of surface receptors (called “checkpoints”) that can help either to sustain activation or suppress T-cell function. Many malignancies have developed ways to exploit these receptors to suppress T-cell function, enabling them to continue to grow. Anticancer immunotherapy in general, and checkpoint inhibitor therapy specifically, is a unique approach to cancer treatment that strives to harness the body’s own immune system to generate an adequate response against cancer cells. Several checkpoint inhibitors are approved for the treatment of metastatic melanoma, non–small cell lung cancer, and renal cell carcinoma. These and other agents in this class are being investigated for their safety and efficacy in a variety of solid and hematologic malignancies. Advanced practitioners (APs) play a critical role in caring for patients treated with checkpoint inhibitors. It is essential for APs to be aware of the mechanism of action of these agents, patterns of response seen with this type of therapy, and presentation of immune-related adverse events related to these agents to ensure timely and successful treatment. Rapid evaluation/diagnostics and treatment are essential for optimal management and prevention of end-organ disease, and treatment of immune-related adverse effects requires a multidisciplinary approach.




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