Building Support Systems: Resources and Multidisciplinary Collaboration for Optimizing COCOON Implementation

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.