Monitoring, Supportive Care, and Managing Expectations

Close monitoring during interleukin-2 (IL-2) therapy is essential for safety. Acute care nurse practitioner Mary Montefusco, ACNP, of Memorial Sloan Kettering Cancer Center walks through the day-to-day checks, including daily weights, careful tracking of fluids in and out, vital signs, and twice-daily labs to watch blood counts, kidney, and liver function. She describes the supportive medications commonly used, including meperidine or hydromorphone for rigors, diphenhydramine and acetaminophen before each dose, antinausea medicine, furosemide for fluid buildup, and antibiotics if a fever develops when the immune system is low. Medical oncologist James Smithy, MD, MHS, discusses the importance of fluid balance and how the team helps prevent swelling. Michael Goldman reflects that while IL-2 was tougher than he expected, the chills were short-lived, and he shares practical advice for anyone going through it, such as bringing extra blankets for the toughest moments.