Kelley Rone on the Evolving Role of Immunotherapy in GI Cancers

The role for immunotherapy has evolved over the past decade for patients with gastrointestinal (GI) cancers, according to Kelley A. Rone, DNP, RN, AGNP-c.

Rone, a nurse practitioner in the GI department at Mayo Clinic in Arizona, will discuss advances in GI Cancer as part of the Physician’s Education Resources’ 6th Annual School of Nursing Oncology™. Ahead of the meeting, Rone met with Oncology Nursing News® to unpack the latest changes in the field.

Treatment options with immunotherapy are still limited for patients with GI cancers compared with other tumor types, says Rone, adding that patients with colon or pancreatic cancer still need to have microsatellite instability–high disease in order to qualify for immunotherapy. However, the recent FDA approval of 2 nivolumab (Opdivo)-based regimens for the frontline treatment of patients with esophageal squamous cell carcinoma, found that the immunotherapy in combination with chemotherapy or ipilimumab (Yervoy), resulted in durable responses in this population, according to findings from the CheckMate 648 trial (NCT03143153).

Moreover, Rone is optimistic about the addition of durvalumab (Imfinzi) to gemcitabine and cisplatin for patients with cholangiocarcinoma, and its potential for improving overall survival compared with chemotherapy alone, especially because, for many patients, immunotherapy is more tolerable, she says.

“Chemotherapy is difficult,” Rone says. “Immunotherapy, in general, is much more tolerable [for] patients. It does not cause all of the toxicities that chemotherapy does.”

Rone notes that immunotherapy does come with a host of adverse effects unique to its class. Therefore, nurses who care for patients receiving immunotherapy must ask more directed questions in order to be aware of subtle immune-mediated toxicities that may occur.