Caring for Patients Treated With Checkpoint Inhibitors for the Treatment of Metastatic Merkel Cell Carcinoma

Abstract

Objective: To provide an overview for oncology nurses about Merkel cell carcinoma and its management with immunotherapy.

Data sources: A literature search was conducted from 2013 to the present using search terms including "Merkel cell carcinoma," "avelumab," "pembrolizumab," "immune-mediated adverse events," and "infusion-related reactions." Clinical experience of the authors was also considered.

Conclusion: Oncology nurses can expect to manage an increasing number of patients with Merkel cell carcinoma because of increased incidence of the disease, as well as evolving immunotherapy treatment paradigms. Both avelumab and pembrolizumab possess favorable safety profiles but are associated with immune-mediated and infusion-related reactions.

Implications for nursing practice: Oncology nurses need to understand Merkel cell carcinoma and be able to recognize the signs and symptoms of immune-mediated adverse events and infusion-related reactions associated with treatment to provide early intervention.

Keywords: Avelumab; Checkpoint inhibitor; Immune-mediated adverse events; Infusion-related reactions; Merkel cell carcinoma; PD-L1 inhibitor; Pembrolizumab.