Clinical Nurse Consultant Support: Management of Patients With Melanoma Receiving Immunotherapy 
and Targeted Therapy

Anna J. Lomax, BSc, MBBS, FRACP; Theresa Nielsen, BN, MCaHaemN, RN; Lydia Visintin, BN, MCaHaemN, RN; Brent O’Carrigan, BSc, MBBS, M.Med (Clin Epi), MRCP; Florian Honeyball, MBBS, FRACP; Benjamin Shum, MBBS; Robyn P.M. Saw, MBBS, FRACS, MS; Catriona McNeil, MBBS, BSc(Med), FRACP, PhD


Background: Targeted therapy and immunotherapy agents for advanced melanoma are associated with novel toxicities. Melanoma clinical nurse consultants (CNCs) provide multifaceted clinical care.

Objectives: The objective was to evaluate the type of support, excluding clinic and inpatient care, provided by CNCs for patients not enrolled in a clinical trial.

Methods: A prospective review of CNC support provided during a 12-week period was conducted.

Findings: From May to August 2015, 105 patients attended clinic, and 72 received CNC support. Initial patient encounters with CNCs were documented (n = 150), as well as additional interactions (n = 291). The most common problem identified per initial encounter was symptom/drug toxicity. The most common therapy-related concern was related to anti-programmed cell death protein 1 immunotherapy and BRAF plus MEK inhibition. CNC interventions commonly involved clinical advice and counseling and care coordination.

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