Becoming Familiar With Patients’ AEs is Essential, Says Expert

When administering first-line avelumab (Bavencio) with axitinib (Inlyta) for advanced renal cell carcinoma (RCC), oncology nurses and advanced practice providers (APPs) should prepare to spend some time managing adverse effects (AEs) with patients, as explained by an expert.

Axel Stuart Merseburger, MD, PhD, spoke with Oncology Nursing News about his research presented at the 2025 ASCO Genitourinary Cancers Symposium, which confirmed the safety and efficacy of the drug combination.¹

Merseburger, chairman of the Clinic of Urology at University Hospital Schleswig-Holstein in Lübeck, Germany, said that while adherence to intravenous therapy is not an issue, the AEs associated with tyrosine kinase inhibitors (TKIs), like axitinib, should be a topic for discussion between patients and providers. Having patients keep diaries can facilitate the monitoring of AEs that may occur and engage patients in the process, he added.

He shared that the role of both oncology nurses and doctors is to spend time getting to know patients’ AEs, their tolerance of those AEs, and how the AEs progress in order to provide the best care, including dose modifications when appropriate.

Transcript

Adherence for [intravenous] therapy is not the problem, because when you give it for the oral [tyrosine kinase inhibitor], I think it’s important to speak about side effects. And most of my patients have a patient diary, which I think is very important, because you tend to forget.

So, you really — when the patient [says] he has diarrhea, this is can be very bothersome. And sometimes the patient [says] it’s twice a day, by definition, or 3 times a day, “It’s diarrhea, but it doesn't bother me,” so it’s something you have to invest some time.

This is mainly the job of the nurses, but also it has to be within the doctor’s hands to really discuss with the patient, the side effects, what can happen, and also when they are there, how to cope them, how to treat them, how to support it, and maybe dose reduce. So, I think that [it] is important to speak about side effects.

Reference

1. Merseburger A, Baklanova O, Garlonta V, et al. Real-world effectiveness and safety of first-line (1L) avelumab + axitinib in patients with advanced renal cell carcinoma (aRCC): primary analysis of the AVION study. J Clin Oncol. 2025;43(suppl 5):474. doi:10.1200/JCO.2025.43.5_suppl.474