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Monitoring Dual ICI

What do I watch for? Watch for immune-related side effects from ICI.
Immune-related side effects can happen to any part of the body. Report any symptom you ICI ICI
think could be a side effect. Some side effects that you should be particularly aware of include:

1 Skin 3 Breathing Problems
• Skin side effects usually happen first and • Report any new or worsening symptoms
are more common than side effects related to your breathing to your cancer
affecting other parts of the body care team.
• Skin-related side effects can include • Symptoms that should be reported to the
rash, itching and/or sores in the mouth cancer care team include trouble
• Report any new itching or rash anywhere breathing that is worse than normal, dry
cough that is new or getting worse or
on the body to your cancer care team
a fever (temperature of 38.3˚C or 38˚C
for over an hour)
2 Diarrhea and/or Bowel Changes
• Report any new diarrhea, cramping in the
belly, and/or blood in the stool to your
cancer care team
• Talk to your cancer care team before
taking anti-diarrhea medications Side effects are more frequent and more severe with
dual ICI combinations than when only one ICI agent
(ie. Imodium )
TM
is used.
(See page 13 in COMMUNICATIONS section for guidance if after hours)

How are ICI side effects treated?

• Immune-related side effects from dual ICI are always treated based on the individual patient. Report all side effects to
your cancer care team.

• DO NOT manage side effects at home without speaking with your cancer care team.

• The earlier an immune-related side effect is recognized, the better it can be managed.

• Serious immune-related side effects (e.g. symptoms that affect daily activities) are usually treated with steroids to
suppress the immune system.

• Steroids act as “water on the fire” and slow down the “activated” immune system.

• More serious side effects may require a long duration of treatment with steroids or other medications to decrease
the immune response (4-8 weeks).

• In some cases, the ICI treatment may need to be held while the side effect is being managed.

• Minor symptoms (e.g. symptoms that are noticeable but do not affect daily activities) may be managed more easily with
advice from your cancer care team.

Adapted from: Horizons Health Network

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