Immunotherapy in Gliomas.

OBJECTIVES: To describe the immunotherapy approaches currently under investigation for the treatment of gliomas. To discuss the management of immune-related adverse effects. DATA SOURCES: Published literature, clinical trials, and oncology association guidance documents. CONCLUSION: There are numerous modalities of immune treatment currently being evaluated in patients with glioma, including peptide vaccines, dendritic cell vaccines, oncolytic viruses, CAR-T cells, and checkpoint inhibitor therapy. Immunotherapy utilizes new mechanisms of treatment that may lead us to the eradication of gliomas. IMPLICATIONS FOR NURSING PRACTICE: Immunotherapy is a rapidly growing field in the treatment of gliomas. Oncology nurses are often involved in the safe administration of these therapies, as well as the identification and management of immune-related toxicities.

Safety and efficacy of glucagon for the relief of acute esophageal food impaction.

PURPOSE: The safety and efficacy of i.v. glucagon for the relief of acute esophageal food impaction were evaluated. SUMMARY: The medical literature was reviewed to identify published trials and case series on the use of i.v. glucagon for the relief of acute esophageal food impaction. Individual case reports and limited case series were excluded from the analysis. This search yielded two retrospective reviews, three prospective reviews, and one randomized, placebo-controlled trial. Only two of the studies analyzed the effect of glucagon alone. Two studies combined this therapy with benzodiazepines, and the other two combined this therapy with an effervescent product and water. Of the two studies that had a control group, one demonstrated no significant difference in the success rate of dislodgement and one showed a nonsignificantly lower success rate in the treatment group. The majority of reports excluded patients with known esophageal strictures and treated a variety of different food-type impactions, making it difficult to determine if the success of this therapy may be tied to a specific subgroup. Few studies documented the adverse effects of this therapy, the most common being nausea and vomiting. Although limited, the available data do not support the use of glucagon for the relief of acute esophageal food impaction. CONCLUSION: Based on the available data, the use of i.v. glucagon for the relief of acute esophageal food impaction is not supported by the literature. In addition, glucagon has the potential to cause adverse effects and decrease the likelihood of spontaneous resolution.