TABLE 2.
Adverse effects targeted by nursing interventions in the included studies.
| Adverse effect domain | Typical toxicities | Targeted therapy classes | Key nursing intervention components | Representative references |
|---|---|---|---|---|
| Dermatologic toxicities | Acneiform rash, xerosis, pruritus, paronychia, hand–foot syndrome, photosensitivity | EGFR-TKIs, multi-targeted TKIs, antibody–drug conjugates, IO–TKI combinations | Prophylactic moisturizers and emollients, sun-protection counselling, avoidance of friction and extreme temperatures, early CTCAE-based grading, standardized skin-care protocols, timely referral to dermatology, patient education on self-care | (Sun et al., 2025; Du et al., 2022a; Diez de los Rios de la Serna et al., 2024; Califano et al., 2015) |
| Peripheral neuropathy | Distal numbness, tingling, burning pain, weakness, gait disturbance, falls | Antibody–drug conjugates, some TKIs | Baseline risk assessment, use of neuropathy scales (e.g., Total Neuropathy Score), functional screening of gait and fine motor skills, safety and fall-prevention counselling, referral to physical and occupational therapy, coordination with physicians on dose modifications | (Zhang et al., 2024) |
| Gastrointestinal toxicity | Diarrhea, nausea, vomiting, stomatitis, mTOR-inhibitor-associated stomatitis | EGFR-TKIs, VEGF-TKIs, mTOR inhibitors, IO–TKI regimens | Dietary counselling and hydration advice, education on appropriate use of anti-emetics and anti-diarrheals, mouth-care and oral-hygiene protocols, structured triage using CTCAE and UKONS tools, telephone follow-up for red-flag symptoms | (Diez de los Rios de la Serna et al., 2024; Parreira et al., 2024; Gao and Guo, 2025) |
| Systemic and hematologic toxicity | Fatigue, anemia, neutropenia, infection risk | Chemotherapy plus targeted agents, IO–TKI combinations | Patient education on infection-prevention and energy-conservation strategies, routine laboratory monitoring, early triage for fever or severe fatigue, coordination of supportive medications (e.g., G-CSF), symptom-specific management algorithms | (Gao and Guo, 2025) |
| Immune-related adverse events | Endocrinopathies (hypothyroidism, hypophysitis), colitis, hepatitis, pneumonitis, cutaneous irAEs | PD-1/PD-L1 inhibitors, CTLA-4 inhibitors | Education on immunotherapy mechanisms and irAE warning signs, systematic review-of-systems assessments, close monitoring for early irAE symptoms, adherence to ASCO and SITC escalation pathways for corticosteroid initiation and treatment interruption, coordination of multidisciplinary care | (Sun et al., 2025; Schneider et al., 2021; Barber, 2019; Shankar et al., 2022) |
EGFR-TKI: epidermal growth factor receptor tyrosine kinase inhibitor; TKI: tyrosine kinase inhibitor; ADC: Antibody-Drug Conjugate; IO: Immuno-Oncology; VEGF: vascular endothelial growth factor; mTOR: mammalian target of rapamycin; CTCAE: common terminology criteria for adverse events; UKONS: united kingdom oncology nursing society; PD-1: Programmed Death Receptor-1; PD-L1: Programmed Death Ligand-1; CTLA-4: Cytotoxic T-Lymphocyte-Associated Protein 4; ASCO: american society of clinical oncology; SITC: society for immunotherapy of cancer; G-CSF: Granulocyte Colony-Stimulating Factor; irAE: Immune-Related Adverse Event.