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

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. 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. 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). Nivolumab-related symptoms are influenced by both treatment-related and individual lifestyle factors. Adequate nutrition and avoiding concurrent chemotherapy may help reduce symptom severity. This study explored the side effects experienced by cancer patients treated with nivolumab, a type of immunotherapy. Researchers interviewed 53 patients and assessed their symptoms and general health. Common problems included skin reactions, constipation, fatigue, and breathing difficulties. The study found that patients receiving chemotherapy alongside nivolumab had more severe side effects. Patients who maintained a healthy and balanced diet had fewer complaints. The findings suggest that careful monitoring and personalized care especially for those also receiving chemotherapy can help reduce symptoms and improve patient well-being