Symptoms, symptom burden, and influencing factors in patients treated with Nivolumab


Akyuz Ozdemir F., Yildirim D., Celik M., CAN G.

Immunotherapy, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1080/1750743x.2026.2626243
  • Dergi Adı: Immunotherapy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE
  • Anahtar Kelimeler: cancer, immunotherapy, Nivolumab, symptom management, toxicity
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Aim: Immune checkpoint inhibitors such as nivolumab are increasingly used in cancer treatment; however, their side effects may significantly affect patients’ well-being and quality of life. This study aimed to determine symptom burden and influencing factors in patients receiving nivolumab immunotherapy. Material and method: This descriptive, cross-sectional study was conducted between October 2024 and January 2025 in a medical oncology clinic. A total of 53 patients receiving nivolumab participated. Data were collected through face-to-face interviews using a patient information form, a 40-item symptom assessment form, and the ECOG Performance Status Scale. Results: The most common symptoms were skin-related toxicities such as itching (18.9%) and dryness (20.8%), gastrointestinal problems like constipation (15.1%), and pulmonary symptoms such as fatigue (17%), cough (17%), and dyspnea (15.1%). Neurological symptoms like numbness and tingling in hands and feet (11.3%) were also reported. Among endocrine toxicities, hypothyroidism was observed in 20.8% of patients. Patients receiving concurrent chemotherapy had significantly higher symptom burden. Additionally, patients with adequate and balanced nutrition reported fewer and milder symptoms. Most patients had good performance status (81.1% fully active). Conclusions: Nivolumab-related symptoms are influenced by both treatment-related and individual lifestyle factors. Adequate nutrition and avoiding concurrent chemotherapy may help reduce symptom severity.