The CLEAR Trial: Lenvatinib Plus Pembrolizumab or Everolimus for Advanced Renal Cell Carcinoma - Episode 6

mRCC: Role of Oncology Nurses in Managing I/O–TKI Adverse Events

Advice to oncology nurses who manage patients with metastatic renal cell carcinoma receiving novel-based therapies, including lenvatinib and pembrolizumab.

Kiran Kehoe, RN, BSN, CCRN: Nurses play a crucial role in the management of patients with advanced RCC [renal cell carcinoma]. They help connect patients to certain resources, such as social work, nutrition, and sometimes even psychiatry. What’s important for the community of oncology nurses managing patients with advanced renal cell carcinoma is to do a thorough assessment on patients with these treatment regimens, specifically lenvatinib-pembrolizumab, because we’ve seen that these adverse events can affect a patient’s quality of life significantly. It’s very important to fine-tune assessments so that these adverse events are caught in advance, so treatment regimens may not necessarily need to be interrupted or discontinued but rather may just need some modifications.

Patients often express their concerns to the nurses. There’s some hesitance from patients to open up to their physicians because they may be afraid that their treatment may be held or stopped. Establishing a good rapport with your patients. Let them know that if they experience any adverse events, have questions, or feel that something isn’t right, they should reach out. Enforcing good communication with the clinical oncology team and the nurse, and having those open discussions related to adverse events, is really important.

That being said, oncology nurses are also very important in managing patients who have advanced renal cell carcinoma because they’re managing the disease but also helping patients cope with the disease itself. Have referrals placed to support groups, to other communities and community groups that are available to patients, so that they feel that they’re being managed not just for physical symptoms but also for mental health issues that may come up.

The role of the oncology nurses is multifactorial. We are the front line in managing patients because they come to us first with their questions, concerns, and adverse events. We help guide the next steps in conjunction with the physician. It’s very important to have a good rapport and an open patient relationship and to let them know that we’re here for them. We want them to continue this treatment regimen and, of course, have a good quality of life.

Transcript edited for clarity.