Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio (Ms Wood); University of Chicago Medicine, Genitourinary Oncology, Chicago, Illinois (Ms Conway); St Bartholomew's Hospital, London, United Kingdom (Ms Lapuente, Mr Salvador, Ms Fernandez Gomez); St George's Hospital, London, United Kingdom (Ms Fernandez Gomez); EMD Serono, Rockland, Massachusetts (Ms Carroll Bullock); Pfizer Inc, New York, New York (Dr Devgan); City of Hope Medical Center, Genitourinary Medical Oncology, Duarte, California (Ms Burns).
Laura S. Wood, MSN, RN, OCN®, is the renal cancer clinical research coordinator at the Cleveland Clinic Cancer Center in Cleveland, Ohio. She completed both her bachelor's and master's degrees in nursing at Kent State University in Kent, Ohio. She is involved in the care of patients with renal and genitourinary cancers. Ms Wood is a member of the Protocol Review and Monitoring Committee, the Immunotherapy Education Committee, and the Immune-Related Adverse Event Tumor Board. She is also active in the local and national Oncology Nursing Society, the American Society of Clinical Oncology, and the Society for Immunotherapy of Cancer. A national and international lecturer on topics related to oncology nursing, Ms Wood has authored many book chapters and journal articles on therapeutic approaches and nursing care in the management of cancer. She was also the recipient of the 2012 Oncology Nursing Society Clinical Lectureship Award.
J Infus Nurs. 2022;45(3):142-153. doi: 10.1097/NAN.0000000000000465.
Immune checkpoint inhibitors, such as programmed cell death ligand 1 inhibitors pembrolizumab, nivolumab, atezolizumab, and avelumab, are used to treat patients with advanced urothelial carcinoma (UC). Based on data from the phase 3 JAVELIN Bladder 100 trial, avelumab first-line (1L) maintenance is now considered the standard-of-care treatment for patients with locally advanced or metastatic UC who responded or experienced disease stabilization after 1L platinum-containing chemotherapy, and it is the only category 1 preferred checkpoint inhibitor maintenance option in the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for patients with cisplatin-eligible and cisplatin-ineligible locally advanced or metastatic UC. This article reviews key considerations related to avelumab 1L maintenance therapy that infusion nurses should be familiar with, including dosing, administration, and immune-related adverse event recognition and management, to ensure safe and appropriate use of this important and impactful therapy.
免疫检查点抑制剂，如程序性死亡配体 1 抑制剂帕博利珠单抗、纳武利尤单抗、阿替利珠单抗和avelumab，被用于治疗晚期尿路上皮癌（UC）患者。基于 3 期 JAVELIN Bladder 100 试验的数据，avelumab 一线（1L）维持治疗现在被认为是标准治疗方案，适用于在 1L 含铂化疗后有反应或疾病稳定的局部晚期或转移性 UC 患者，并且它是在 National Comprehensive Cancer Network 临床实践指南中的唯一类别 1 首选检查点抑制剂维持选择，适用于适合顺铂和不适合顺铂的局部晚期或转移性 UC 患者。本文综述了与 avelumab 1L 维持治疗相关的关键注意事项，输注护士应该熟悉这些注意事项，包括剂量、给药以及免疫相关不良事件的识别和管理，以确保这种重要且有影响力的治疗的安全和适当使用。
