At Global Voices in Renal Oncology (VIRO) 2025, organized by OncoDaily, Archana Ajmera, Adult Nurse Practitioner at UC San Diego Health delivered a talk on “Management of IO/TKI Toxicity”. She emphasized that these side effects are not necessarily treatment contraindications but require shared decision-making, multidisciplinary collaboration, and patient education.
The CTCAE grading system is central for assessing toxicity severity in both clinical trials and practice and guides nursing teams when triaging patients over the phone.
Dermatologic toxicities are the most common immune-related events, often appearing in the first or second cycle, with symptoms like itching or maculopapular rashes. Incidence varies: up to 45% with ipilimumab and around 34% with PD-1/PD-L1 inhibitors. Most cases are manageable with topical therapies, oral antihistamines, and emollients, while oral steroids are reserved for severe reactions.
Other important IO/TKI side effects include hand-foot syndrome, wound healing complications, hypertension, gastrointestinal toxicities, liver function changes and fatigue. Early recognition, grading, and proactive management allow most patients to safely continue treatment.
Archana highlighted that careful monitoring and individualized care are key to minimizing toxicity while maintaining treatment efficacy.
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