The Multidisciplinary Approach to Care for Advanced NSCLC
Panelists discuss how managing amivantamab-related adverse events such as leg edema requires understanding of underlying mechanisms (hypoalbuminemia) and may benefit from albumin infusion, dose holds, or consultation with specialists for severe cases such as infected scalp wounds.
Successful management of advanced non–small cell lung cancer with targeted therapies requires a comprehensive multidisciplinary approach that extends beyond the traditional oncologist-patient relationship. The care team typically includes specialized nursing staff for triage and patient communication, advanced practice providers for ongoing management and education, clinical pharmacists for drug interaction monitoring and dosing optimization, and various specialists as clinically indicated. This collaborative model ensures comprehensive patient support while optimizing treatment outcomes through specialized expertise in different aspects of care.
Technology integration has enhanced patient care delivery, particularly through secure messaging platforms that allow patients to communicate concerns and share photographs of developing adverse effects. This real-time communication capability prevents delays in addressing toxicities and enables proactive intervention before symptoms become severe or require dose modifications. The nursing team serves as the primary triage point for patient concerns, with established protocols for escalating issues to appropriate team members based on symptom severity and clinical urgency.
Specialist consultations play crucial roles in managing specific toxicities and comorbidities associated with targeted therapy. Dermatology consultation is frequently used for complex skin toxicities that require specialized intervention beyond standard prophylactic measures. Other specialists may include cardiology for cardiovascular monitoring with certain agents, endocrinology for metabolic complications, and palliative care for comprehensive symptom management and quality-of-life optimization. The palliative care team integration from diagnosis provides an additional layer of support for symptom management, psychosocial needs, and care coordination, enhancing overall patient experience and treatment tolerance throughout the cancer journey.
