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


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

IMMUNOTHERAPY, vol.18, no.1, pp.25-35, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.1080/1750743x.2026.2626243
  • Journal Name: IMMUNOTHERAPY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE
  • Page Numbers: pp.25-35
  • Istanbul University Affiliated: No

Abstract

AimImmune 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 methodThis 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.ResultsThe 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).ConclusionsNivolumab-related symptoms are influenced by both treatment-related and individual lifestyle factors. Adequate nutrition and avoiding concurrent chemotherapy may help reduce symptom severity.