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Side effects in melanoma patients receiving adjuvant interferon alfa-2b therapy: a nurse’s perspective

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Abstract

Purpose

The aim of this review was to examine the toxicity profile of adjuvant interferon (IFN) alfa-2b in melanoma patients from a nursing perspective and to summarize practical information to guide the effective management of common IFN toxicities to improve patient comfort.

Methods

This is a narrative summary of both research and review articles identified by searching PubMed, National Cancer Institute, and American Cancer Society websites. It also assesses recognized guidelines on the management of adjuvant IFN toxicity relevant to nurses who are caring for patients receiving adjuvant IFN therapy.

Results

Adjuvant high-dose IFN alfa-2b (HDI) as compared with observation significantly prolongs relapse-free survival in patients with melanoma at high risk for recurrence after surgical resection; however, treatment compliance and patient quality of life can be compromised by its toxicity profile. HDI toxicities affect a number of organ systems and the majority of patients will experience some side effects. Common toxicities such as flu-like symptoms, fatigue, anorexia, neuropsychiatric symptoms, and laboratory abnormalities are discussed, along with both pharmacological and nonpharmacological management strategies.

Conclusions

The considerable side effects of HDI can be managed using established strategies. Oncology nurses play a significant role in the management of patients with melanoma receiving adjuvant HDI, and their prompt recognition of side effects, together with an understanding of effective pharmacological and nonpharmacological interventions, will improve patient comfort; this has the potential to positively influence treatment adherence and completion of the recommended treatment course.

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Acknowledgment

Editorial assistance was provided by Helen Varley, PhD, UBC-Envision Group, Horsham, UK; this assistance was supported by Merck & Co. Inc.

Author disclosure statement

Krista M. Rubin had a consultant/advisory role for Bristol-Myers Squibb, Merck & Co. Inc., and Genetech. Suzanne McGettigan has received remuneration from Merck & Co. Inc. Karen Vona, Kathleen Madden, and Ilana M. Braun have nothing to disclose.

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Authors and Affiliations

  1. Center for Melanoma, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Yawkey Building Suite 9E, Boston, MA, 02114, USA

    Krista M. Rubin

  2. Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

    Karen Vona

  3. Clinical Cancer Center, New York University Langone Medical Center, New York, NY, USA

    Kathleen Madden

  4. Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, PA, USA

    Suzanne McGettigan

  5. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA

    Ilana M. Braun

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  1. Krista M. Rubin
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  2. Karen Vona
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  5. Ilana M. Braun
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Correspondence to Krista M. Rubin.

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Rubin, K.M., Vona, K., Madden, K. et al. Side effects in melanoma patients receiving adjuvant interferon alfa-2b therapy: a nurse’s perspective. Support Care Cancer 20, 1601–1611 (2012). https://doi.org/10.1007/s00520-012-1473-0

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  • DOI: https://doi.org/10.1007/s00520-012-1473-0

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