Rationalising immunosuppressants, immunotherapy and oral anticancer drugs in palliative care

Follow the principles of medication rationalisation when rationalising immunosuppressants, chemotherapy and immunotherapy in palliative care.

For patients with palliative care needs who have cancer, discuss the benefits and harms of continuing immunotherapy, oral cancer chemotherapy or targeted anticancer drugs with the patient’s oncologist.

Immunosuppressants and immunotherapy are used for a range of indications including rheumatoid arthritis, inflammatory bowel disease, and prevention of transplant rejection. In these cases, immunosuppressants and immunotherapy are generally preventing and managing symptoms, and are often continued until the last days of life. Discuss with the patient’s specialist to develop a management plan when the patient is approaching end of life.

For principles of palliative care for patients with cancer, see Principles of palliative care for patients with cancer.