Given that access to ophthalmologists can be a significant bottleneck for patients, it is acceptable and practical for routine monitoring of mirvetuximab-related ocular side effects to be managed by optometrists. This pragmatic approach improves accessibility while ensuring patient safety.

When managing drug-induced rash, recurrence is often caused by restarting therapy before the initial rash has completely resolved. Patients may be eager to resume treatment and minimize lingering symptoms, so clinicians must explicitly educate them on the need for full resolution to prevent a cycle of recurrence.

Broad-spectrum RAS-on inhibitors like daraxonrasib present skin toxicity as a dose-limiting side effect. However, this rash is clinically distinct from that caused by EGFR inhibitors. It is often manageable with brief treatment interruptions, frequently without requiring dose reductions, and patients tend to acclimate to it over time.

When educating staff and patients about immunotherapies, it is helpful to distinguish between the desired effect (cytokine release killing cancer cells) and the dangerous toxicity (CRS). This reframing clarifies that CRS is an over-expression of the drug's intended mechanism, not a separate, unrelated side effect.

When managing ocular toxicity from the ADC mirvetuximab, clinicians advocate for delaying the subsequent dose to allow the cornea to heal naturally. This approach is often preferred over an immediate dose reduction, which might unnecessarily compromise the treatment's efficacy.

The onset of ocular symptoms from mervituximab is highly predictable, almost always starting between days 10 and 14 of the second treatment cycle. Proactively warning patients about this specific timeline can reduce their anxiety if and when symptoms appear.

Patients receiving systemic immunotherapy for advanced skin cancer are still at high risk for developing new, low-risk primary skin cancers. Medical oncologists should not act as default dermatologists; ongoing co-management is crucial to identify and treat these new lesions while the patient is on systemic therapy.

Loncastuximab Tesirine (Lanka-T) can cause a unique "third spacing" side effect, leading to significant edema and fluid retention that is resistant to common diuretics like furosemide (Lasix). Spironolactone has proven more effective for managing this specific toxicity, representing a key clinical pearl for nurses and prescribers.

Unlike chemotherapy, immune-related adverse events have a delayed onset. Nurses must educate patients that toxicities can appear long after treatment initiation and even after its conclusion, requiring long-term vigilance.