Aims
To evaluate the implementation and early outcomes of a nurse practitioner-led immunotherapy supportive care clinic in a regional cancer centre, focusing on immune-related adverse event (irAE) management, supportive care delivery, and health promotion for patients receiving immune checkpoint inhibitors.
Methods
Consecutive patients receiving immunotherapy at a regional cancer centre were referred to a nurse practitioner-led immunotherapy supportive care clinic. Reviews alternated with treating medical oncologist appointments. Patients underwent retrospective assessment of prior immunotherapy-related adverse events and prospective assessment of supportive care needs during ongoing therapy. Demographics, cancer diagnosis, treatment, comorbidities, supportive care interventions, health behaviours, and irAEs were collected. Retrospective and prospective irAE’s were compared.
Results
Fifty-two patients attended 80 clinic reviews. Lung cancer was the most common diagnosis (38.5%), followed by melanoma and upper gastrointestinal cancers (15.4% each). Over 40% of patients had two or more comorbidities.
Compared with irAEs identified prior to clinic enrolment, newly identified irAEs during clinic follow-up were less frequent (9% vs 29%), less likely to be grade ≥3 (14% vs 39%), and more commonly managed conservatively with observation or topical corticosteroids (86% vs 22%).
Supportive care interventions were delivered at every review, with symptom management the most common intervention (54%), followed by education (25%). Exercise assessment was completed in 43 reviews; 88% reported regular moderate physical activity, with 70% exercising 3–7 days per week for approximately 30 minutes per session.
Conclusions
A nurse practitioner-led immunotherapy supportive care clinic is a feasible model for integrating toxicity surveillance, supportive care, and health promotion within a regional cancer service. Early findings suggest earlier identification of irAEs, lower toxicity severity, and increased use of conservative management strategies. This model may improve access to comprehensive supportive care for patients receiving immunotherapy in regional settings.