Building Support Systems: Resources and Multidisciplinary Collaboration for Optimizing COCOON Implementation
Panelists discuss how keeping management of dermatologic adverse effects “in-house” with oncology teams is often preferable to referring patients to dermatologists, though some patients occasionally benefit from specialized care for nail issues.
Video content above is prompted by the following:
Multidisciplinary Approach to Amivantamab-Related Dermatologic Adverse Effects
Current Management Approach
The discussion highlights a preference for managing amivantamab-related dermatologic adverse effects “in-house” rather than routinely referring to dermatology for several practical reasons:
Limited dermatology appointment availability (typical 2-month wait times)
Patient burden considerations (multiple appointments, additional co-pays)
Better continuity of care when treated by the primary oncology team
Recognition that these adverse effects are treatment-related and predictable
Additional Support Resources
Several supportive care measures were identified:
- Some patients independently sought specialized care:
- Podiatry consultation for toenail issues, including curettage for granuloma tissue
- Occasional dermatology referrals that sometimes-yielded novel management strategies
- Suggested workflow improvements:
- Prebuilt order sets for prophylactic oral and topical antibiotics
- Standardized patient education materials (1-page handout or brochure)
- Comprehensive supportive care toolkit outlining:
- Adverse effects to monitor
- Recommended preventive regimens
- Management strategies
- Existing resources:
- Electronic medical record may already contain standardized order sets
Recommendations for Practice Enhancement
The summary suggests a COCOON regimen approach that appears to be a standardized protocol for managing amivantamab-related dermatologic toxicities, with emphasis on streamlining implementation through:
- Systematic prophylactic measures
- Patient education and anticipatory guidance
- Reducing administrative burden through standardized ordering processes
This approach balances comprehensive toxicity management while minimizing additional appointments and maintaining continuity within the oncology care team.
Newsletter
Stay up to date on recent advances in the multidisciplinary approach to cancer.
Prolaris in Practice: Guiding ADT Benefits, Clinical Application, and Expert Insights From ACRO 2025
April 15th 2025Steven E. Finkelstein, MD, DABR, FACRO discuses how Prolaris distinguishes itself from other genomic biomarker platforms by providing uniquely actionable clinical information that quantifies the absolute benefit of androgen deprivation therapy when added to radiation therapy, offering clinicians a more precise tool for personalizing prostate cancer treatment strategies.
CCR Scores and Beyond: Precision Strategies for Treatment Intensification in Prostate Cancer
April 15th 2025Alvaro Martinez, MD discusses how emerging genomic risk stratification tools such as the clinical cell-cycle risk (CCR) score are transforming personalized prostate cancer treatment by enabling more nuanced assessments of metastasis risk and treatment intensification strategies beyond traditional NCCN risk groupings.
