APHON Pediatric Chemotherapy-Biotherapy Renewal

Table 1. Immune Checkpoint Inhibitors and Indications for Use Name of Immune Checkpoint Inhibitor Generic (Trade) Receptor/Ligand

Indication for Use

Second-line metastatic non-small cell lung cancer, advanced or metastatic urothelial carcinoma Advanced or metastatic urothelial carcinoma, metastatic Merkel cell carcinoma

Atezolizumab (Tecentriq)

Anti–PD-L1

Avelumab (Bavencio)

Anti–PD-L1

Durvalumab (Imfinzi)

Anti–PD-L1

Advanced or metastatic urothelial carcinoma

Ipilimumab (Yervoy)

Anti-CTLA4

Metastatic melanoma, stage III melanoma

Metastatic melanoma, second-line metastatic non- small cell lung cancer, second-line metastatic renal cell carcinoma, refractory classical Hodgkin lymphoma, recurrent/metastatic squamous cell carcinoma of the head and neck Advanced/metastatic urothelial carcinoma Metastatic melanoma, second-line metastatic non- small cell lung cancer, first- and second-line metastatic renal cell carcinoma, refractory classical Hodgkin lymphoma, recurrent or metastatic squamous cell carcinoma of the head and neck Advanced or metastatic urothelial carcinoma Microsatellite instability–high or mismatch repair deficient metastatic solid tumors

Nivolumab (Opdivo)

Anti–PD-1

Pembrolizumab (Keytruda)

Anti–PD-1

Data from “Neurological Toxicities Associated with Immune-Checkpoint Inhibitors,” by M. Touat, D. Talmasov, D. Ricard, and D. Psimaras, 2017, Current Opinion in Neurology , 30 (6), 659–668. https://doi.org/10.1097/WCO.0000000000000503.

Neurotoxicities related to these agents include immune-related adverse events (IRAEs) of both the central and peripheral nervous systems. Although they occur only rarely, it is important for the nurse to be able to recognize the IRAEs that ICPIs can cause in order to avoid complications or further deterioration of the patient’s status ( Table 2 ).

Table 2. Immune-Related Adverse Events Associated with Immune Checkpoint Inhibitors Immune-Related Adverse Event Name of Immune Checkpoint Inhibitor

Nivolumab Pembrolizumab Ipilimumab

Acute immune demyelinating polyneuropathy

Aseptic meningitis

Ipilimumab