Pharmaceutical care, cancer, immunotherapy, immune checkpoint inhibitors, toxicity

Pharmaceutical care is integrated with cancer patient care in a variety of ways, ranging from antineoplastic drug control to clinical follow-up and oncological therapeutic implications. Immunological checkpoint inhibitors (ICIs), a kind of immunotherapy using monoclonal antibodies used in the treatment of various types of malignancies, are among the potential new therapeutic options in the oncological field. However, although promising, the toxicity of ICIs, such as immune system-related adverse events (irEAs), can impact the outcome of treatment. The pharmacist is the professional who seeks to prevent, identify and solve problems related to medicines, thus being essential for the care of the oncological patient in treatment with ICIs. The aim of this work was to assess the contribution of the pharmacist in the therapeutic monitoring of the oncological patient in treatment with ICIs. In this way, an integrative review of studies of oncological patients treated with ICIs and that had the participation of the pharmacist was carried out in the databases: Pubmed, Scopus, Embase and Web of Science. 2152 studies were obtained, of which 52 studies were selected for the evaluation of the full text on the basis of inclusion and exclusion criteria. Following this analysis, eight studies with a total of 739 participants (68% male and 32% female) were chosen and included in this integrative review. Participants in six research had an average age of more than 60 years. The most common type of cancer was lung cancer, followed by melanoma. The immunological toxicity of ICIs was observed in various body systems. Pharmaceutical care has been present in patient care through prescription-free medication recommendations, monitoring and management of toxicities, pharmaceutical consultations, patient guidance, caregivers, physicians, and multidisciplinary staff, as well as activities that helped to identify toxicities early and alleviate symptoms. The assessed studies included significant information that may aid in the creation of individualized pharmaceutical care for patients receiving ICIs for cancer treatment. However, there is still a limitation in the details of some information, signaling the need for more and more specific studies for this patient profile. Thus, it is concluded that pharmaceutical care in the context of oncological immunotherapy with ICIs can provide positive impacts both for health institutions, by reducing costs or minimizing waste, and, mainly, for patients, in the outcome of treatment and in improving the quality of life.