Oncology Nursing News: The Vitals: Recent Episodes

View Details

In this special episode of The Vitals, we ring in the New Year 2024 by combing through 2023 FDA approvals. Listen as editor, Lindsay Fischer, recounts key approvals on a month-by-month basis. To read the full information surrounding the approvals, be sure to check out our news coverage below.

As always, thank you for listening to The Vitals, and for all the engagement in 2023. We look forward to bringing you more oncology news in 2024.

We want to hear from you! Which drugs approved in 2023 have been practice changing? Have you had any difficulty or success in incorporating these novel agents into clinical use? Any challenges with supporting patients on these regimens? Email ONNeditors@mjhlifesciences.com with your feedback
January
Tucatinib and Trastuzumab Combination Gains FDA Approval for RAS Wild-Type HER2+ mCRC * FDA Approves Zanubrutinib for CLL/SLL * Adjuvant Pembrolizumab Gets FDA Approval in NSCLC * FDA Grants Pirtobrutinib Accelerated Approval for Relapsed/Refractory MCL*

February
Sacituzumab Govitecan Receives Indication for Unresectable, Locally Advanced or Metastatic HR+/HER2- Breast Cancer * FDA Grants Regular Approval to Dostarlimab for dMMR Endometrial Cancer*

March
Abemaciclib Indication Expands to Include HR+, HER2–, Node+, High-Risk, Early Breast Cancer * FDA Approves Single-Dose Autoinjector of Biosimilar Pegfilgrastim-cbqv for Febrile Neutropenia * FDA Approves Dabrafenib With Trametinib for Pediatric BRAF V600E–Mutant Low-Grade Glioma * FDA Grants Accelerated Approval to Retifanlimab for Locally Advanced Merkel Cell Carcinoma * Pembrolizumab Receives Full FDA Approval for Treatment of Select Patients With dMMR/MSI-H Solid Tumors*

April
FDA Grants Accelerated Approval to Enfortumab Vedotin Plus Pembrolizumab for Locally Advanced or Metastatic Urothelial Cancer * Omidubicel-onlv Gets Greenlight to Accelerate Neutrophil Recovery After Stem Cell Transplant in Hematologic Malignancies * Polatuzumab Vedotin Approved in Combination With R-CHP for Treatment-Naïve DLBCL, High-Grade B-Cell Lymphoma*

May
Cemiplimab Granted Full Approval for Metastatic Basal Cell Carcinoma * Epcoritamab Obtains Accelerated Approval for Relapsed/Refractory DLBCL * FDA Greenlights Avapritinib for Indolent Systemic Mastocytosis * FDA Approves Radiohybrid PET Diagnostic Agent Posluma for PSMA-Positive Lesions in Prostate Cancer * Olaparib Gains FDA Approval for BRCA+ mCRPC*

June
Glofitamab Gains Accelerated Approval for Relapsed/Refractory DLBCL * FDA Approves Talazoparib in Combination With Enzalutamide for mCRPC * Blinatumomab Receives Full Approval for MRD-Positive B-Cell ALL*

July
Ready-to-Dilute Cyclophosphamide Injections Obtain FDA Approval * Quizartinib Plus Chemo Gains FDA Approval for Newly Diagnosed, FLT3-ITD+ AML * FDA Approves Frontline Dostarlimab in Combination With Chemotherapy for dMMR/MSI-H Endometrial Cancer*

August
FDA Approves Trifluridine/Tipiracil With Bevacizumab for Metastatic Colorectal Cancer * Pralsetinib Gains Regular Approval for NSCLC With RET Gene Fusions * Talquetamab Receives Accelerated Approval for Heavily Pretreated Multiple Myeloma * FDA Approves Niraparib Plus Abiraterone Acetate to Treat BRCA+ mCRPC * FDA Grants Elranatamab Accelerated Approval for Relapsed or Refractory Multiple Myeloma * FDA Approves Hepzato Kit for Metastatic Uveal Melanoma With Liver Metastases*

September
FDA Approves Motixafortide Plus G-CSF to Mobilize Hematopoietic Stem Cells in Multiple Myeloma * FDA Approves Momelotinib to Treat Myelofibrosis With Anemia * Bosutinib Is Approved for Pediatric Ph+ CP–Chronic Myeloid Leukemia*

October
FDA Grants Marketing Authorization to First DNA Test to Assess Multiple Cancer Predispositions * FDA Approves Encorafenib/Binimetinib for BRAF V600E+ NSCLC * FDA Approves Adjuvant Nivolumab for Stage IIB/C Melanoma * Pembrolizumab/Chemotherapy is Approved for Neoadjuvant and Adjuvant Resectable Non-Small Cell Lung Cancer * Entrectinib Is Approved for Pediatric Patients With NTRK+ Solid Tumors * FDA Approves Ivosidenib to Treat Myelodysplastic Syndromes With IDH1 Mutation * FDA Approves Toripalimab Regimens to Treat Adults With Nasopharyngeal Carcinoma*

November
FDA Grants Pembrolizumab New Biliary Tract Cancer Indication * FDA Approves Fruquintinib for Patients With Pretreated Metastatic Colorectal Cancer * FDA Approves Repotrectinib for Adults With Advanced/Metastatic ROS1+ NSCLC * Pembrolizumab Is Approved for Patients With HER2– Gastric/GEJ Adenocarcinoma * FDA Approves Capivasertib/Fulvestrant for Advanced/Metastatic, HR+, HER2- Breast Cancer * FDA Approves Enzalutamide for High-Risk Nonmetastatic Castration-Sensitive Prostate Cancer * FDA OKs Nirogacestat for Adults Patients With Desmoid Tumors*

December
FDA Grants Pirtobrutinib Accelerated Approval to Treat CLL/SLL in the Third Line * FDA Approves Eflornithine for Children, Adults With High-Risk Neuroblastoma * FDA Approves Belzutifan for Patients With Advanced Renal Cell Carcinoma * Enfortumab Vedotin Plus Pembrolizumab Snags Full Approval for Patients With Locally Advanced or Metastatic Urothelial Cancer*

View Details

In this episode of The Vitals, Beth Finley-Oliver, MSN, ARNP, AGNP-BC, a nurse practitioner who works in the outpatient hematology clinic at Moffitt Cancer Center, revisits her presentation from the 2023 JADPRO Live Annual Meeting and discusses the growing number of therapies for patients with relapsed or refractory multiple myeloma.

Episode Highlights“A clinical trial upfront would be my first option. After that, I have to try and find something their myeloma hasn't seen yet.”

“With CAR T, the CRS incidence is higher, and I think we're doing better [at managing it] because we have multiple interventions. We see viral infections with [both] the CAR T and the bispecifics. We always have to kind of keep that in the back of our mind.”

“The more medications we have, the more this is turning into a chronic illness.”

For More On Multiple Myeloma:
Delivering Teclistamab in the Outpatient Setting * Ambulation Improves Frailty Scores in Patients With Multiple Myeloma * With New Bispecific Antibodies in Multiple Myeloma, Nurses Need To Know How to Manage CRS*

Video Interviews
Managing Teclistamab-Induced CRS for Patients With Multiple Myeloma * Data Supporting Elranatamab Approval in Multiple Myeloma * Data Behind Talquetamab Approval in Multiple Myeloma*

More Podcast Episodes
Beth Faiman Discusses Recent Changes in Multiple Myeloma Treatment Landscape * ASH Data Offer Treatment Direction for Oncology Nursing Professionals * A Look Back at 2022 FDA Approvals in Oncology * Conversations Around Selinexor: Best Nursing Practices in Multiple Myeloma*

View Details

In May 2023, the FDA granted accelerated approval to epcoritamab-bysp (Epkinly) for the treatment of adult patients with relapsed/refractory (R/R) DLBCL, including DLBCL arising from indolent lymphoma, and high-grade B-cell lymphoma (HGBL), following 2 or more lines of systemic therapies. Shortly thereafter, in June 2023, the FDA granted accelerated approval to glofitamab-gxbm (Columvi) as a fixed duration treatment for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) not otherwise specified or large B-cell lymphoma (LBCL) arising from follicular lymphoma, after 2 or more lines of systemic therapy.

In this episode of The Vitals, Laura Zitella, MS, RN, ACNP-BC, AOCN, who is a hematology nurse practitioner in the Hematology, Blood, Marrow transplant, and Cellular Therapy (HBC) program at UCSF Health and associate clinical professor in the Department of Physiological Nursing at the University of California San Francisco, joins Oncology Nursing News to discuss how these newly approved bispecific antibodies are expanding third-line treatment options for patients with diffuse large B-cell lymphoma.

Episode Highlights

“Bispecific antibodies are antibodies that generally have at least 2 antigen binding sites: 1 binding site is to the antigen of interest on the cancer cell, and in lymphoma, that's often CD19, or CD20. The other antigen binding site is to CD3, which is a T-cell marker.”

“Unfortunately, we do not cure all patients with second-line therapy [and] the bispecifics are used for third-line therapy, where we have historically had limited treatment options.”

“One of the big advantages of bispecific antibodies is that they are ‘off-the-shelf;’ they do not need to be manufactured, and they are available immediately."

“Epcoratimab is a subcutaneous [administration] bispecific antibody, whereas glofitamab is an intravenous [administration]. Both require step-up dosing, which means that you start with a small dose and then the subsequent doses are a little bit higher, and a little bit higher until you reach your treatment dose.”

For More on DLBCL Glofitamab Gains Accelerated Approval for Relapsed/Refractory DLBCL * Epcoritamab Obtains Accelerated Approval for Relapsed/Refractory DLBCL * Investigators Unveil Real-World Experiences on Shared Decision-Making in R/R DLBCL*

For More On Bispecific Antibodies
With New Bispecific Antibodies in Multiple Myeloma, Nurses Need To Know How to Manage CRS * Novel Immune Checkpoint Inhibitors, Bispecific Antibodies Become Clinical Mainstays in Melanoma Nursing * Smith Discusses Evolving Landscape of Lymphoma Treatments * Bispecific Antibodies May Change Lung Cancer Paradigm*

More Podcast Episodes in Hematology
Beth Faiman Discusses Recent Changes in Multiple Myeloma Treatment Landscape * Oncology Nursing Stories: Off-The-Shelf CAR T Therapy for Acute Lymphoblastic Leukemia * Oncology Nursing Stories: Pregnancy After Lymphoma Chemoradiation * Conversations Around Selinexor: Best Nursing Practices in Multiple Myeloma * Stephanie Jackson Unpacks Recent Advances in Leukemia Treatments*

View Details

In honor of lung cancer awareness month, for this episode of The Vitals, Nicole Gay, APRN-C, joins Oncology Nursing News to share how she counsels patients about lung cancer screening.

Gay is a nurse practitioner at the University of Miami Sylvester Comprehensive Cancer Clinic, and a nurse navigator for the clinic’s lung cancer screening program. In the conversation, she shares how she addresses patient fears and concerns around screening, helping them feel comfortable and confident in navigating their health.

Episode Highlights

“Lung cancer screening, unfortunately, has a bit of a stigma around it. Part of my job is reducing that stigma, making patients feel comfortable and relaying how important screening for lung cancer really is.”

“This is a low-dose CT scan. The amount of radiation they are getting is reduced when you compare it to a normal CT scan.”

“We are very grateful for the change in the guidelines. It really widened the pool of patients that can be screened.”

Online Articles
How I Counsel Patients About Lung Cancer Screening * Innovative Patient Education Strategies Continue to be Developed for Lung Cancer Screening * Opinion: Cancer Screenings, Although Not Perfect, Remain Valuable * Updates in Lung Cancer Screening Criteria Increase African American Patient Participation*

Videos
Johanna Garibaldi On Strengthening Cancer Prevention Tactics With Mobile Screening Clinics * Confidence Is Key in Oncology Nurse Navigation*

References
1. Lung cancer: screening. US Preventive Services Task Force. March 19, 2021. Accessed August 16, 2023. https://uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening 2. Lung cancer screening billing guide. American Lung Association. Accessed August 30, 2023. https://www.lung.org/getmedia/bd0af1bf-1cd8-4fd0-9f8f-47e55c783448/ALA-Lung-Cancer-Screening-Billing-Guide-FINAL.pdf 3. Cancer facts and figures 2021. American Cancer Society. Accessed August 16, 2023. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2021.html 4. Lung nodules. American Cancer Society. Accessed August 16, 2023. https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/lung-nodules.html 5. Lung cancer screening. Mayo Clinic. February 11, 2022. Accessed August 30, 2023. https://www.mayoclinic.org/tests-procedures/lung-cancer-screening/about/pac-20385024 6. Lung cancer screening: questions for the doctor. US Department of Health & Human Services. Updated May 26, 2023. Accessed August 18, 2023. https://health.gov/myhealthfinder/doctor-visits/talking-doctor/lung-cancer-screening-questions-doctor

View Details

In this episode of The Vitals, Holly Chitwood, DNP, FNP-C, AGACNP-BC, walks through a patient case with a 70-year-old male with metastatic colorectal cancer.1 His providers used circulating tumor DNA (ctDNA) testing to monitor his minimal residual disease (MRD) levels throughout active treatment. This approach, although not currently addressed in National Comprehensive Cancer Center Guidelines, allows patients and providers to have an idea of how the treatment is working earlier compared with what imaging can usually demonstrate, she explains.

Chitwood is an assistant professor in the College of Nursing at the University of Kentucky, as well as a practicing oncology APRN who primarily cares for patients with gastrointestinal, hepatic-biliary, and sarcoma tumors in her clinic. To read the full case study, please check out our show notes below.

Episode Highlights

“This is a new technology that we have. It is basically looking at what is in your blood to see how much circulating tumor DNA is floating around.”

“In this case, and in a lot of my patients, you will see ctDNA is about, you know, anywhere from 2 to 3 months [ahead], predating what you will see on imaging.”

“You have to be very judicious in explaining the results, especially if you have a positive result, and the patient should be included in the decision making.”

Online Articles

• ctDNA Continues to Emerge As A Potentially Useful Disease Monitoring Tool in CRC
• ctDNA Makes Headway as Promising Marker for Patients With Anal Cancer and Other GI Malignancies
• ESMO Guideline on Liquid Biopsy Address Quality Standards for Clinical Implementation
• New Treatment Methods Launch a Shift in CRC Treatment

Videos

• Metastatic CRC Nursing Webinar

Podcast
Terri Pollack Offers Perspective on 2023 ASCO GI Cancers Symposium * Overcome Screening Barriers in CRC*

References
1. Chitwood H, Myers A. Use of circulating tumor DNA to monitor minimal residual disease among patients with colorectal cancer. Clin J Oncol Nurs. 2023;27(4):369-374. doi:10.1188/23.CJON.369-374

View Details

In this episode of The Vitals, Patricia Jakel, RN, MN, AOCN, co–editor-in-chief with Oncology Nursing News, sits down with Quanna Batiste-Brown, DNP, RN, NEA-BC, FAAN, to discuss the reality of racism in nursing. Batiste-Brown is an adjunct associate professor and Chief Nursing Officer at UCLA health.

The pair discuss the implications of the National Commission to Address Racism in Nursing, which, in 2021, published survey findings from 5,623 nurses. The findings showed that 50% of nurses feel that there is “a lot” of racism in nursing; that 63% of nurses have personally experienced racism in the workplace; and that 56% of nurses say that racism has impacted their mental health in the workplace.

Moreover, although 3 out of 4 nurses have witnessed racism in the workplace, 64% of those who actively challenged racism or stood up for their colleagues said their actions effected no change.

Batiste-Brown, who is part of California ANA and helped created a workforce in her group that led to the larger ANA’s commission on nursing report, discussed the implications of racism in nursing, and offered insight in how to talk to administration and coworkers about creating an inclusive community that protects employees and promotes better patient care.

Episode Highlights
“Nurses across the state were really upset and tired and wanted to do something about their own lived experiences, [and the] experiences of their patients. [They] wanted to talk about what nurses could do to affect change in racism and health equity, or the care that they are delivering and what their patients were experiencing.”

“There is opportunity for everyone to come together to have honest conversations about how we move change forward.”

“Be mindful of someone's mental health and be sure that they're not keeping that information inside of them, because it can be detrimental to your health to be going through something as severe as racism and not tell anyone about it.”

Podcast Episodes
Equity, Diversity, and Inclusion in Oncology Nursing Leadership * Championing Diversity in Nursing and Oncology*

Oncology Nursing News Articles
The Future of Nursing Must Be Diverse * Nurse Leaders Must Foster Change to Develop a Healthy Workplace Environment * Diversity and Inclusion Should be Valued in Leadership Roles * Creating a Safe Space: Preventing Bullying and Violence Among Oncology Nurses*

Video Interviews
Establishing Equity, Diversity, and Inclusion Throughout Oncology Practice * Starting the DEI Conversation in Oncology Nursing*

References
1. Our Racial Reckoning Statement. American Nurses Association. Accessed October 11, 2023. https://www.nursingworld.org/practice-policy/workforce/racism-in-nursing/RacialReckoningStatement/

1. National Commission to Address Racism in Nursing. Accessed October 11, 2023. https://www.nursingworld.org/practice-policy/workforce/racism-in-nursing/national-commission-to-address-racism-in-nursing/

View Details

In this episode of The Vitals, Ryan Tamargo, NP, AONCP, a nurse practitioner with the inflammatory breast cancer (IBC) program at the Dana-Farber Cancer Institute, talks about IBC and why it is often misdiagnosed. She discusses the launch of an online IBC Scoring System tool, which was developed through Susan G Komen, the Milburn Foundation, and the Inflammatory Breast Cancer Research Foundation. According to Tamargo, this tool may prove helpful in raising awareness about this rare form of breast cancer and make it easier for primary care providers to recognize the symptoms and make the correct diagnosis.

Resource

Inflammatory Breast Cancer (IBC) Scoring System online tool

Episode Highlights
“What can be tricky about [IBC] is that there is sometimes no mass. The symptoms can be very progressive that it can look like an infection to primary care providers or providers in the community.” Time stamp (TS) 1:48

“The tool can be really helpful in going step-by-step [through] what you're actually seeing, and then will give you a score at the end." TS 4:00

“The best thing to prevent this [from] becoming metastatic is going to be treatment with chemotherapy as soon as possible.” TS 9:30

Online Articles

• Inflammatory Breast Cancer Is Often Missed, But May Now Be Easier to Diagnose
• Fast Facts for the Frontline: Inflammatory Breast Cancer
• Raising Awareness of Inflammatory Breast Cancer
• The Argument for Better Patient-Centered Care in Oncology
• USPSTF Suggests Lowering Breast Cancer Screening Age in Draft Recommendation

The Vitals Podcast Episodes
Nurse Practitioners Weigh in on Data From the San Antonio Breast Cancer Symposium
Video Interviews
Kara Morris and Christine Wylie on Oral Cryotherapy for Chemotherapy-Induced Mucositis in Breast Cancer * Johanna Garibaldi On Strengthening Cancer Prevention Tactics With Mobile Screening Clinics * Pattie Jakel Highlights the Challenges With Oral Therapies in Breast Cancer*

Reference
Jagsi R, Mason G, Overmoyer BA, et al. Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research. Breast Cancer Res Treat. 2022;192(2):235-243. doi:10.1007/s10549-021-06434-x

View Details

In this episode of The Vitals, Heather Santone, an oncology nurse navigator with Allegheny Health Network, shares which unique challenges nurse navigators face when caring for geriatric patients. She points out that many of these patients have difficulty securing transportation to and from their appointments, or struggle to navigate online applications or internet services. Luckily, nurse navigators can play a large role in helping patients overcome these obstacles and ensuring that patients do not fall through the system’s cracks.

Episode Highlights

I live in Erie; we are a smaller city. A lot of our testing has to be done in Pittsburgh. Time stamp (TS) 5:56

Transportation is a large barrier to care for older people because [oftentimes] they have stopped driving, and they may not have the transportation. TS 7:28

Technology is huge, because a lot of our services, like American Cancer Society’s great Road-to-Recovery program, is on an App—they give us [a 1-800] number so we can call in, but a lot of things, like Lyft goes back to an app or a computer system. TS7:37

The nice thing about navigation is the that we are there to help prevent the gaps. For the most part, we do a really good job of keeping those gaps very small, to make sure we are trying to follow [patients] all the way through treatment so that they are not lost.” TS 10:07

Online Articles

• Defining and Quantifying the Oncology Nurse Navigator Role
• Geriatric Assessments Help Guide Meaningful Cancer Treatment
• Geriatric Assessment Rates Improve With Nurse Navigator Intervention
• Geriatric Assessments Help Promote Comorbidity-Related Discussions in Patients With Advanced Cancer

Video Interviews:

• Setting Boundaries Can Be a Challenge for Nurse Navigators
• Supriya Mohile on Lack of Representation of Geriatric Patients in Clinical Trials
• Claire Friedman on Considerations for Older Patients Receiving Immunotherapy

Podcast Episodes:

• Leana Cabrera Chien and William Dale Underscore The Value of Geriatric Assessments in Optimizing Cancer Care
• Access-Focused Care: The 4-1-1 on Oncology Phone Triage Programs
• Preparing Nurses for the 'Silver Tsunami'
• Behind Integrated Behavioral Health Services

View Details

In this episode of The Vitals, Shawna Douglas, BSN, RN, a head and neck oncology nurse navigator with Allegheny Health Network, highlights the unique challenges that this population faces, including access to proper dental care, nutrition specialists, and postsurgery speech and swallow therapy. She draws from personal experience to share a story of how she used the resources available at her institution to help a patient find transportation to and from her appointment—highlighting the value that nurse navigators can provide their patients.

Episode Highlights
“My role as their oncology navigator is to help be that one point of contact and to guide them through their cancer journey. I provide additional information resources, referrals, and support.” Time stamp (TS) 1:49

“They always need a dietician to follow them, [they may have] possible feeding tube considerations, [and] they always need to see a dentist regardless of treatment options. Patients also need that dental clearance if they are going to be receiving radiation to the head and neck. Stemming from the dental evaluation, a lot of our patients need to see an oral surgeon for some extractions.” TS 3:41

“There are sometimes issues with noncompliance because there are so many appointments that need to be scheduled. They get very overwhelmed. That's where I come in.” TS 4:37

Articles
Advances in Head and Neck Cancers Yield New Clinical Implications for Nurses * Investigators Say HPV Vaccination Rates Are Suboptimal * Virtual Planning For Surgical Reconstruction May Improve Outcomes for Patients With Head and Neck Cancer * Defining and Quantifying the Oncology Nurse Navigator Role*

Videos Setting Boundaries Can Be a Challenge for Nurse Navigators * Confidence Is Key in Oncology Nurse Navigation * Referring Patients to the Right Support Group*

Podcasts

• Are Hearing Tests Necessary For Adult Cancer Survivors?
• Access-Focused Care: The 4-1-1 on Oncology Phone Triage Programs

View Details

In this episode of The Vitals, Oncology Nursing News® spoke with Linda Bloom, MPA, RN, OCN, about strategies to improve communication among patients with limited English proficiency who are admitted to surgical oncology. Bloom, who is a clinical nurse IV at Memorial Sloan Kettering Cancer Center, presented on this topic during the 48th Annual Oncology Nursing Society Meeting, and the findings have been published in the Clinical Journal of Oncology Nursing.

As Bloom explains in the discussion, perianesthesia nurses and language assistance staff joined forces to improve communication for patients with limited English proficiency, including those with hearing, speech, or visual impairments. Nurses were provided with tablets embedded with 2 video interpreter applications, as well as smart phones and wearable communication devices with audio interpreter options. American Sign Language interpreters were available through the video interpreter tablets so that nurses could communicate with hearing impaired patients, and clear masks were distributed so that these patients could lip read. White boards were provided to help communication with non-verbal patients, and magnifiers and voice recorders were used to help improve communication with visually impaired patients.

Overall, the introduction of these devices allowed patients have a voice during their presurgical assessment and ensured that the information being discussed was accurate and clear. Moreover, by leveraging trained medical interpreters who understand medical terminology, nurses and health care staff could ensure that patients were fully informed of the procedures they would need to have.

“Patient safety should always be the priority,” Bloom told Oncology Nursing News. “Accurate and precise communication ensures that patient safety is prioritized to the highest degree.”

Episode Highlights:

“When the patient had to go to the room for the procedure, she clutched the amplifier and earpiece and tried to grab the mic. [She] said, ‘You can't take this away—I haven't been able to hear since I [got] here.’” Time stamp (TS) 7:33

“The Creole language speaking assistant heard him before the interpreter had [time] to tell me and texted his daughter. I immediately knew we had to get a social worker involved.” TS 10:22

“Some of [this technology] is very low tech: a whiteboard for a patient who is nonverbal. They love it… people don't realize it's easier than pen and paper because you can erase it; you can write more.” TS 12:33

Oncology Nursing News Articles

• Opinion: New Technology Can Help Improve Patient Communication in the Oncology Setting
• Audiological Assessments May Be Vital Component of Cancer Survivorship Care Following Chemotherapy
• Navigator Offers Strategies to Support Non-English Speaking Patients
• Opinion: Clear Communication Is A Form Of Patient Advocacy

The Vitals Podcasts

• Are Hearing Tests Necessary For Adult Cancer Survivors?
• A Chat on Communication Barriers in Childhood Cancer

Video Interviews

Better Understanding Your Patient's Situation

References

1. Bloom L. Nurses take on language access. Presented at 48th Annual Oncology Nursing Society Congress. April 25-30, 2023; San Antonio, TX. Accessed June 15, 2023.https://ons.confex.com/ons/2023/qi/eposterview.cgi?eposterid=2528

2. Bloom L. Improving communication for surgical patients with cancer with limited English proficiency. Clin J Oncol Nurse. 2023;27(4):359-363. doi: 10.1188/23.CJON.359-363

View Details

In this episode of The Vitals, Oncology Nursing News® spoke with Leana Cabrera Chien, MSN, RN, GCNS-BC, GNP-BC, and William Dale, MD, PhD. The pair discuss the value of geriatric assessments in optimizing cancer care for older adults, especially considering the recent update to the American Society of Clinical Oncology (ASCO) guidelines, stating that all patients with cancer who are older than 65 years should receive a geriatric assessment.

The update emphasizes the overarching recommendations from the previous guidelines, except that the new guidelines are based on data which suggest that geriatric assessments can improve patient outcomes and are therefore a critical component of quality care.

Both Cabrera Chien, who is a nurse practitioner in the Center for Cancer and Aging at City of Hope, and Dale, who is vice chair for academic affairs in the Department of Supportive Care Medicine at City of Hope, as wellthe director of City of Hope’s Center for Cancer and Aging, were investigators on the pivotal GAIN trial (NCT02517034), which was one of the large randomized clinical trials that supported the ASCO guideline update.2,3 The findings from this research demonstrated that when patients undergoing chemotherapy receive geriatric assessments, they experienced fewer treatment-related toxicities—preserving quality of life—without affecting survival outcomes. According to these specialists, geriatric assessments also improve patient and caregiver satisfaction, communication surrounding aging concerns, and the completion of advanced directives.

Episode Highlights

“The importance of the GA is how it is individualized with each patient.” Time stamp (TS) 4:42

“Since this visit, she has written to us and told us how thankful she is for the care she received at City of Hope. Utilizing the GA really [helped us] find out what this patient needed, and we met that need” TS 7:38

“When we developed the PGA, we asked a lot of nurses, because we knew that they were going to be the key to giving us the real-time, real-world implementation guidance that would be needed to take these academic studies like GAIN and put them into the actual practice.” TS 10:00

Oncology Nursing News Articles:

• ASCO States That All Older Adults With Cancer Should Receive Geriatric Assessments
• Geriatric Assessment Intervention Helps Reduce Symptom Burden for Older Patients With Advanced Cancer
• Geriatric Assessment Rates Improve With Nurse Navigator Intervention
• Geriatric Assessments Help Promote Comorbidity-Related Discussions in Patients With Advanced Cancer

Video Interviews:

• Supriya Mohile on Lack of Representation of Geriatric Patients in Clinical Trials
• Claire Friedman on Considerations for Older Patients Receiving Immunotherapy

Podcast Episodes:

• Preparing Nurses for the 'Silver Tsunami'
• Behind Integrated Behavioral Health Services

References

1. Dale W, Klepin HD, Williams GR, et al. Practical assessment and management of vulnerabilities in older patients receiving systemic cancer therapy: ASCO guideline update. J Clin Oncol. Published online July 17, 2023. doi:10.1200/JCO.23.00933
2. Li D, Sun CL, Kim H, et al. Geriatric assessment-driven intervention (GAIN) on chemotherapy-related toxic effects in older adults with cancer: a randomized clinical trial. JAMA Oncol. 2021;7(11):e214158. doi:10.1001/jamaoncol.2021.4158
3. Mohile SG, Mohamed MR, Xu H, et al. Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study. Lancet. 2021;398(10314):1894-1904. doi:10.1016/S0140-6736(21)01789-X

View Details

In this episode of The Vitals, Oncology Nursing News® spoke with Jacki Garcia, RN, BSN, CNRN; and Kristen Hendrickson, BA, RN, to discuss phase 0 trials, also known as window-of-opportunity trials, in neuro-oncology.

Phase 0 trials are designed to identify new drugs capable of slowing tumor progression in patients who face poor prognoses. Patients who enroll in a phase 0 trial receive a subtherapeutic dose of an agent prior to undergoing surgery. When the tissue is resected, investigators determine whether the agent penetrated the blood-brain barrier and whether the agent had the anticipated effect. If the agent demonstrates therapeutic effect, patients may be able to continue the treatment going forward. According to Garcia, who is a nurse navigator, and Hendrickson, who is a research program manager, both with the Ivy Brain Tumor Center at Barrow Neurological Institute, phase 0 trials are important because they offer patients with brain tumors another potential treatment option.

The nurses note that despite the prevalence of malignant brain tumors with poor prognoses, such as glioblastoma, they are on the frontline of a lot of exciting research efforts, and are optimistic about the trajectory of the treatment paradigm.

“There are long-term survivors out there,” Garcia said. “I have seen them. So, for [individuals] who have a view of this disease is that this as a terminal diagnosis, just know that there is some element of hope out there. “

Episode Highlights

“Once it has been determined that the patient is a surgical candidate and is being recommended for a phase 0 trial, then the research nurse team has discussions with the patient where we talk about the requirements for the clinical trial. We make sure that they can consent [to] the clinical trial, [that] they meet the inclusion criteria for the trial and do not meet any of the exclusion criteria. We are looking at the whole picture.” Time stamp 2:44

“There are different courses for each patient, but we want to make sure that they are exploring every avenue possible [to] treat [patients with] this diagnosis.” TS 11:47

“As an institute, [and] a clinical trials program, we really want to reach underserved populations who may have no knowledge of clinical trials. It is really important that those populations know that there are multiple treatment options to consider so they can make the best-informed decision for themselves and their families.” TS 11:56

Oncology Nursing News Articles:

• Vorasidenib Demonstrates PFS Benefit in IDH-Mutant Low-Grade Glioma
• Investigational CAR T Product GD2-CART01 Displays Safety and Efficacy in Pediatric Neuroblastoma
• Chemoimmunotherapy Yields Promising Objective Responses in Patients With High-Risk Neuroblastoma
• Reirradiation May Play a Role in Recurrent Glioblastoma, Although Optimal Treatment Remains Controversial
• Clinical Trials Continue to Propel Field of Oncology with Nurses on The Frontline

Video Interviews:

• ManmeetAhulwalia on Targeting the Blood-Brain Barrier With Novel Immunotherapies and Precision Oncology
• Kathryn Beal on Aftercare for Patients with Primary Brain Tumors
• Anita Mahajan on the Nurse’s Role When Treating Patients with Brain Cancer

The Vitals Podcast:

• A Look Back at 2022 FDA Approvals in Oncology
• Focus on ‘A Different Kind of Hope’ in Cancer

References

1. Vogelbaum MA, Krivosheya D, Borghei-Razavi H, et al. Phase 0 and window of opportunity clinical trial design in neuro-oncology: a RANO review. Neuro Oncol. 2020;22(11):1568-1579. doi:10.1093/neuonc/noaa149

2. Siegel, RL, Miller, KD, Wagle, NS, Jemal, A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17- 48. doi:10.3322/caac.21763

View Details

In this episode of The Vitals, Clint Koerkenmeier, MHS, BSN, RN, joins Oncology Nursing News® to discuss retention strategies at his institution.

Koerkenmeierisassociate nursing officer at the Vanderbilt-Ingram Cancer Center, which is a National Cancer Institute–designated cancer center which recently received its 4th Magnet Recognition. It was also named as a best place to work by the American Association for Men in Nursing.

As Koerkenmeier points out in the discussion, Vanderbilt is home to multiple initiatives intended to improve nurse satisfaction and support lateral career development. Some of these programs include a tuition reimbursement program, where nurses can receive up to $8000 a year for their education, Daisy awards, and certification support. The center also sponsors staff whose abstracts are selected for the Oncology Nursing Society (ONS) Congress. This year 13 Vanderbilt nurses presented their research at the ONS Congress, according to Koerkenmeier.

Lastly, Koerkenmeier explains how the Vanderbilt Professional Nurse Practice Program (VPNPP) improves nurse satisfaction at his institution.

“It helps us to retain nurses, because they know that they can grow here without having to leave,” he says.

We want to hear from you! How does your institution boost nurse enthusiasm and retain employees? Email lfischer@mjhlifesciences.com

Episode Highlights

“We started a specific oncology orientation, to give people the backstory of the of the cancer center and our 13 locations. We think it is important to make sure that they see and are reminded that they are part of something bigger than just being a Vanderbilt nurse. It helps you remind us of the mission, [of] why we all went into nursing, and [of] why we are in oncology.” Time stamp (TS) 2:56

“Another thing we do is leadership rounds. The associate operating officer and I will round through the clinics weekly, to talk about what we can do differently, what the frontline staff need and [if] nothing else, make sure they know that we are here for them.” TS 5:39

“[The VNPPN] gives us a “carrot” to help encourage our nurses to get certified. We pay for the certification, but then we also give them a raise for it.” TS 7:37

Oncology Nursing News® Online Articles:

• After Recruiting Oncology Nurses, Focus on Retention
• Structured Onboarding Processes Boost Employee Retention
• Uncracking the Code on Oncology Nurse Satisfaction During a Magnet® Journey
• Recruitment and Retention Efforts Address Oncology Nursing Shortage

The Vitals Podcast:

• The Value of Nurse Mentorship in Oncology
• Equity, Diversity, and Inclusion in Oncology Nursing Leadership

Video Interviews:

• Elizabeth Loach on Integrating Frontline Staff in Nursing Task Forces
• Aliènne Salleroli on Starting the DEI Conversation in Oncology Nursing

References

1. Our magnet designation. Vanderbilt University Medical Center. Accessed June 29, 2023. https://www.vumc.org/vanderbilt-nursing/our-magnet-designation

1. Batcheldor M. VUMC named best workplace for men in nursing. Accessed June 29, 2023. https://www.vumc.org/vanderbilt-nursing/vumc-named-best-workplace-men-nursing

2. Vanderbilt professional nursing practice program (VPNPP). Vanderbilt University Medical Center. Accessed June 29, 2023. https://www.vumc.org/vpnpp/what-is-vpnpp

View Details

For this episode of The Vitals, Oncology Nursing News® talks with Lauren Mahon, MSN, FNP-BC, about the role of PARP inhibitors in the treatment of ovarian cancers. Mahon, a family nurse practitioner specializing in gynecologic oncology at the University of Rochester, recently presented on this class of therapeutics during the 48th Annual Oncology Nursing Society Congress.

Onsite at the Congress, Mahon discussed the potential benefit of oral maintenance therapy with PARP inhibitors, the importance of genetic testing in this setting, and the different toxicity profiles associated with these treatments.

Niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca), are approved by the FDA for the treatment of patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer in the maintenance setting. Niraparib is approved as a maintenance therapy for adult patients who are in a complete, or partial response to first-line platinum-based chemotherapy. It is also approved as a maintenance treatment for adult patients with deleterious or suspected deleterious germline BRCA-mutated disease who are in a complete or partial response to platinum-based chemotherapy.

Olaparib is approved as a maintenance treatment for adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in a complete or partial response to platinum-based chemotherapy; it is also approved as a maintenance treatment for adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced disease who are in complete or partial response to first-line platinum-based chemotherapy; and it is approved as a maintenance therapy, in combination with bevacizumab (Avastin) for patients with advanced disease who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency–positive status defined by either: a deleterious or suspected deleterious BRCA mutation, and/or genomic instability.

Rucaparib is approved as a maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer whose disease harbors a deleterious germline or somatic BRCA mutation following either a partial or complete response to platinum-based chemotherapy.

Although controversy surrounds these drugs in other settings, Mahon explains that they offer patients some peace of mind and freedom in the maintenance setting, as they minimize recurrence risk without forcing patients to come in for regular intravenous (IV) infusions.

“Oral medications, in general, give you more flexibility,” she said. “People have their quality of life back. They’re not tied to an IV every 3 to 4 weeks. They can go and travel they can spend time with their family members.”

Episode Highlights

What I’ve seen throughout my practice is that, once we are done with the IV chemotherapy: patients are saying—what’s next? What else can I do to make sure that I have the highest chance that this does not come back? Time stamp (TS) 1:55

They have hematologic toxicities, but the main PARP inhibitor that causes anemia and thrombocytopenia is niraparib. TS 4:40

Doing that genetic testing both—for themselves and their family members—is really important. TS 6:00

Further ReadingOncology Nursing News® Articles:

• Nurses Play Key Role in Facilitating Maintenance Therapy With PARP Inhibitors in Ovarian Cancer
• Olaparib Maintenance Yields Long-Term Remission for Women With BRCA+ Ovarian Cancer
• Post-hoc Analysis Shows Maintenance Niraparib Provides Additional Antitumor Activity in Advanced Ovarian Cancer
• Rucaparib Maintenance Extends Progression-Free Survival in Advanced Ovarian Cancer
• Real-World Data Identify Significant Differences in Tolerability Among Approved PARP Inhibitors in Ovarian Cancer

Video Interviews

• Paula Anastasia Emphasizes Importance of Genetic Testing in Selecting Maintenance Therapy for Ovarian Cancer
• Expert Weighs In On The Future of PARP Inhibitors

The Vitals Podcast:

• Bringing a New Approach to Symptom Management in Ovarian Cancer
• A Look Back at 2022 FDA Approvals in Oncology

References

1. Zejula. Prescribing information. GlaxoSmithKline; 2020. Accessed June 6, 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208447s015s017lbledt.pdf

2. Lynparza. Prescribing information. AstraZeneza; 2023. Accessed June 6, 2023. https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/00997c3f-5912-486f-a7db-930b4639cd51/00997c3f-5912-486f-a7db-930b4639cd51_viewable_rendition__v.pdf

3. Rubraca. Clovis oncology, Inc; 2022. Accessed June 6, 2023. https://clovisoncology.com/pdfs/RubracaUSPI.pdf

View Details

In this episode of The Vitals, Seth Eisenberg, ASN, RN, OCN, BMTCN, discusses ongoing research efforts to quantify the value of toilet seat covers in oncology care settings.

As Eisenberg explains, health care professionals who care for patients with cancer are at an increased risk of developing health issues because of their chronic exposure to the hazardous drugs. Specifically, the bathroom represents a repeated source of exposure, as this is where residue from these harmful substances is often found. To that end, Eisenberg, and a co-investigator, sought to test the efficacy of 2 interventions designed to reduce the spread of hospital toilet contaminants.

“Both interventions were virtually equal in effectiveness,” he says. “They reduced the particles by at least 99%.”

Episode Highlights

“ONS has been recommending using plastic-backed pads for covering toilets for patients getting chemotherapy for a long time, [but] there’s really not been a lot of evidence on that.” Time stamp (TS) 1:46

"Both interventions were virtually equal in effectiveness, they reduced the particles by at least 99%." TS 4:03
“We actually did the testing at 2 heights, we [tested] right above the toilet level and at 40 inches. That 40-inch area was chosen because that is within what we call the inhalation zone.” TS 4:16
Oncology Nursing News® Articles:

• Splashblocker Shows Promise in Reducing Spread of Hospital Toilet Contaminants
• USP <800>: Still a Work in Progress?
• Hazardous Drugs and Reproductive Effects: Understanding the Risks
• New Safety Requirements for Nurses Handling Antineoplastic Agents

Video Interviews:
Seth Eisenberg Compares the Effectiveness of Plastic-Backed Pads Vs The Splashblocker in Reducing Toilet Aerosols * AnnMarie Walton on Reducing Antineoplastic Drug Residue in Inpatient Units * Kim Christen on Safe Handling for Hazardous Drugs * Amy Callahan on Barriers to Safe Handling*

References Eisenberg S, Cai C. A comparison of plastic-backed pads to Splashblocker in reducing toilet aerosols. Presented at: 48th Annual Oncology Nursing Society Annual Congress; April 27-May 1, 2022; San Antonio, TX. Accessed April 25, 2023. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/13249 * Eisenberg S, Cai Changjie. Comparing two methods of reducing hospital toilet aerosols. Clin J Oncol Nurse.* 2023;27(2):191-197. doi:10.1188/23.CJON.191-197

View Details

On this episode of The Vitals, Oncology Nursing News® talks with Amber Pierce RN, BSN, OCN, regional nurse manager at Oncology Hematology Associates, an American Oncology Network partner practice, about the importance of 2-step verification with nivolumab and relatlimab-rmbw (Opdualag), which was approved for patients with unresectable or metastatic melanoma in March 2022.

The FDA approval was supported by data from the phase 2/3 RELATIVITY-046 trial (NCT03470922), which demonstrated that patients who received nivolumab/relatlimab as a frontline treatment experienced a median progression-free survival (PFS) that was double that of patients who received nivolumab alone.

As Pierce highlights in the discussion, the combination is novel because relatlimab is a LAG-3 inhibitor. Moreover, the combination was approved as a fixed dose regimen comprised of a single intravenous infusion of 480 mg nivolumab and 160 mg relatlimab to be given every 4 weeks. Because of this, it is important that nurses understand the potential risk of medication errors.

“I think that’s what makes it really unique, because there are other drugs that have a combination of 2 drugs in them, but they may be dosed only on 1 of the drugs that’s in that vial; whereas this particular drug is a flat dose of 640 [mg],” Pierce says.

“That is where there can be some confusion and some misunderstanding between how we are actually dosing these patients,” she adds.

Episode Notes
“Opdualag is a combination of nivolumab and relatlimab; it is a new combination of the PD-1 inhibitor, which is your nivolumab and the LAG-3 blocking antibody, which is your relatlimab.” Time stamp (TS) 4:13
“It is really important for nurses to understand and pay attention to what the drug amount is [with] the medication that they are infusing and [that they are] double checking.” TS 6:56.

“As a nurse, we are the last line of defense, so to speak, before [therapies] reach the patient. As nurse, it is our responsibility to make sure that patient safety is a top priority.” TS 8:37
Podcast

• A Look Back at 2022 FDA Approvals in Oncology

Online Articles

• Independent 2-Nurse Verification Process in Distribution of Oral Investigational Chemo/Immunotherapy Proves Helpful
• Updated PFS Data Continue to Support Nivolumab Plus Relatlimab in Advanced Melanoma
• Experts Provide an Institutional Perspective on the Safe Handling of Immunotherapy Treatments

Video Interviews

• Stephanie Jackson on Improving the Double Verification Process For High-Alert Medications
• Expert Talks Significance of Relatlimab/Nivolumab Approval for Metastatic Melanoma

Reference
1. US Food and Drug Administration approves first LAG-3-blocking antibody combination, Opdualag (nivolumab and relatlimab-rmbw), as treatment for patients with unresectable or metastatic melanoma. News release. Bristol Myers Squibb; March 18, 2022. Accessed May 16, 2023. https://bit.ly/3wk6PDx

View Details

In this episode of The Vitals, Krista M. Rubin, RN, MS, FNP-BC, joins Oncology Nursing News® to discuss best nursing practices with tebentafusp-tebn (Kimmtrak) for patients with unresectable or metastatic uveal melanoma. Rubin is a nurse practitioner with the Center for Melanoma at Massachusetts General Hospital, with over 20 years of experience caring for patients with melanoma. She is also the chair of the Melanoma Nursing Initiative.

Tebentafusp was approved in January 2022 for the treatment of patients with unresectable or metastatic uveal melanoma in adult patients whose disease harbors HLA-A02:01. Findings from the phase 3 IMCgp100-202 trial (NCT03070392) showed that patients who received this agent experienced superior overall survival than patients who received investigators choice of therapy (HR, 0.51; 95% CI, 0.37-0.71; P* < .0001).

As Rubin highlights in the discussion, cytokine release syndrome and rash are some of the most common adverse events (AEs) observed with the bispecific antibody. A step-up dose is used to ease patients onto treatment. Patients are admitted to inpatient care for the first 3 infusions to observe their reactions; however, according to Rubin, after that third cycle, management of AEs becomes straightforward and if patients show positive responses, they can continue to receive a weekly dose indefinitely.

Episode Notes:

Discussion Highlights:

The drug is it's intravenous; it is given in our outpatient clinic, however, patients are admitted to the hospital overnight. Time Stamp 6:37
If there was a serious case of CRS, then these patients would get medications, specifically tocilizumab, to minimize the effects. TS 7:38
With nurses that are able to proactively identify and know how to manage [AEs], patients can do extremely well. TS12:52

Online Articles
FDA Follow-Up: Utilizing Tebentafusp in Clinical Practice for Metastatic Uveal Melanoma * FDA Approves Tebentafusp to Treat HLA-A02:01 Positive Uveal Melanoma * Tebentafusp Boosts Survival in Metastatic Uveal Melanoma**

Podcasts
A Look Back at 2022 FDA Approvals in Oncology*

Videos
Newly Approved Tebentafusp Requires Up-Front Active Toxicity Management in Melanoma * More for Melanoma: Nurse Discusses Unmet Needs * First-in-Human Trial for Tebentafusp In Advanced Melanoma Shows Promising Safety Profile*

View Details

In this episode of The Vitals, Beth Faiman, PhD, CNP, weighs in on the current trajectory of research and clinical practice in multiple myeloma.

Faiman is a nurse practitioner and researcher with the Cleveland Clinic, as well as a board member of the NP/PA Center of Excellence in Multiple Myeloma. According to her, one of the biggest changes of late was the publication of a study in Lancet Discovery, findings of which suggest that patients with biomarker-defined defined disease, as well as 60% or more bone marrow plasma cells (BMPCs), or a free light chain ratio (FLCratio) of at least 10, have a longer time to progression and a lower 2-year progression risk than was previously believed. Whereas the median time to progression was previously reported to be 9.2 months, the new study found the median time to be 30.1 months. Moreover the 2-year progression risk was 45.45%, rather than the previously reported 85.21%.

As Faiman points out, in 2014, the International Myeloma Working Group had added patients with at least 60% BMPCs, FLCratio equal to or greater than 100, and greater than 1 MRI-defined focal lesion of at least 5 mm (SLiM CRAB multiple myeloma) to the diagnostic category of multiple myeloma. However, this newer review suggests that this classification may need to be revisited.

Faiman also touches on shifts in approved BCMA-directed therapies for patients, namely, the accelerated approval of teclistamab-cqyv (Tecvayli) in October of 2022, and the removal of belantamab mafodotin-blmf (Blenrep) from the market in November 2022. She notes that there are ongoing efforts to reincorporate belantamab mafodotin into clinical practice and that she is optimistic about reintroducing this treatment back into her practice—as the dosing schedule and toxicity profile was favorable for patients.

Episode Notes
“Supporting [a] patient while they are in their maintenance phase [of treatment]; checking the blood counts, keeping up [with] health maintenance, making sure their bones are strong and all those other supportive care things, are so important.”

“If you have a heavily pretreated patient on some of the new cellular therapies or bispecifics, that they have to be admitted to the hospital, we have to logistically manage who’s going to be admitted on what day and when.”

“The nice thing about belantamab was that it was an [intravenous] IV [therapy] every 3 weeks, it is directed against BCMA, and it was very well tolerated.”
The Vitals Podcast: * ASH Data Offer Treatment Direction for Oncology Nursing Professionals * A Look Back at 2022 FDA Approvals in Oncology * Conversations Around Selinexor: Best Nursing Practices in Multiple Myeloma

Oncology Nursing News® Online Articles:
Hematologic Oncology Undergoes Transformation With Drug Updates and Approvals * Teclistamab-cqyv Snags Accelerated Approval for Relapsed or Refractory Multiple Myeloma * Belantamab Mafodotin Will No Longer Be Available For Multiple Myeloma * Ocular Visits Are a Necessity for Patients With Multiple Myeloma Who Receive Belantamab Mafodotin*

References
1. Ludwig H, Kainz S, Schreder M, Zojer N, Hinke A. SLiM CRAB criteria revisited: temporal trends in prognosis of patients with smoldering multiple myeloma who meet the definition of ‘biomarker-defined early multiple myeloma’-a systematic review with meta-analysis. EClinicalMedicine. 2023;58:101910. doi:10.1016/j.eclinm.2023.101910

1. FDA approves teclistamab-cqyv for relapsed or refractory multiple myeloma. FDA. October 25, 2022. Accessed April 10, 2023. https://bit.ly/3f3HffB

2. GSK provides an update on Blenrep (belantamab mafodotin-blmf) US marketing authorization. News release. GlaxoSmithKline. November 22, 2022. Accessed April 10, 2023. http://bit.ly/3gniPi1

View Details

In this episode of The Vitals, Lindsay Diamond, MSN, AGNP-C, AOCNP, spoke on updated data from the CheckMate 274 trial (NCT02632409), which were presented during the 2023 ASCO Genitourinary Cancers Symposium (ASCO GU), and commented on different trials paving the way in urothelial carcinoma.

According to Diamond, who is a nurse practitioner and clinical program manager of the GU Oncology Clinical Trials Department at the Icahn School of Medicine at Mount Sinai, the disease-free survival (DFS) outcomes from Checkmate 274 were very promising, as they signify that adjuvant treatment with nivolumab (Opdivo) may be able to help patients reach certain milestones. This trial showed that at a median follow-up of 36.1 months, the median DFS with adjuvant nivolumab was 52.5 months vs 8.4 months with placebo in the PD-L1 population (1% or greater). Moreover, in the intention-to-treat population, the median DFS were 22.0 vs 10.9 months, respectively.

Adjuvant nivolumab was approved for patients with urothelial carcinoma who are at high risk of recurrence after radical resection based on earlier data from CheckMate 274.

Moving forward, she hopes to continue to see positive readouts from this trial, as well as more research in bladder-sparing treatment approaches and better tumor markers to help patients track their diseases responses to treatment.

Interested in learning more from the meeting? Check out our coverage of 2023 ASCO GU here.

We want to hear from you! Which ASCO GU data do you think will be practice-changing?

Email lfischer@mjhlifesciences.com with your feedback.

Episode Notes:
"There is this mentality when patients have localized disease, of ‘well, it’s not metastatic and you had it removed so you’re fine,’ but those patients still live with cancer every day of their life after that surgery and it’s a waiting game." Time stamp (TS) 3:05

"We, as providers, know that 30% of patients or so could have a serious immune-related adverse effect from immunotherapy, but the majority of patients are going to do fine on it." TS 5:17

"Generally, clinical trials looking at bladder sparing approaches [are important], whether it’s our study HCRN GU16-257 [NCT03558087]—that looks at chemotherapy and immunotherapy—or other trials that look at just chemotherapy." TS 6:47

Oncology Nursing News® Online Articles
· CheckMate 274 Follow-Up Supports the Use of Adjuvant Immunotherapy in Bladder Cancer
· Pembrolizumab Shows Antitumor Activity at 45-Month Follow-Up in BCG-Unresponsive Papillary NMIBC
· Real-World Data Supports Front-Line Maintenance With Avelumab For Locally Advanced, Metastatic Urothelial Carcinoma
· Neoadjuvant Split-Dose Chemotherapy Represents Potential New Standard of Care for High-Risk UTUC
· Maximizing Potential of Immunotherapy Requires Appropriate irAE Management

Video Interviews

· Laura Wood on the Integration of Avelumab, Erdafitinib, and Enfortumab Vedotin into Urothelial Cancer Care
· Predicting Immunotherapy Response in Bladder Cancer
The Vitals Podcast
· Chemo Cheat Sheets Help Nurses During Drug Delivery
· A Look Back at 2022 FDA Approvals in Oncology

References
1. Galsky M, Witjes JA, Gschwend J, et al. Extended follow-up results from the CheckMate 274 trial. J Clin Oncol. 2023;41(suppl 6):LBA443. doi:10.1200/JCO.2023.41.6_suppl.LBA443

1. FDA approves nivolumab for adjuvant treatment of urothelial carcinoma. FDA. News release. August 19, 2021. Accessed April 3, 2023. https://bit.ly/3ztbkfm

View Details

It takes a special skillset for nurses to care for patients whose disease continues to relapse after multiple lines of therapy, shares Stephanie Jackson, DNP, MSN, RN, AOCNS, BMTCN.

“I tell my younger staff who aren’t used to seeing patients this sick, ‘even if that patient doesn’t survive, what an honor for us to be a part of their journey,’” she tells Oncology Nursing News®.

For this episode of The Vitals, Jackson, an oncology and bone marrow transplant clinical nurse specialist and unit director at UCLA Medical Center, recalls the story of a patient with acute lymphoblastic leukemia (ALL) who relapsed following treatment with induction chemotherapy and whose disease did not respond to blinatumomab (Blincyto). The team chose to give this patient an off-the-shelf CD22-directed CAR T-cell therapy—which was successful, until the patient ultimately relapsed 6 weeks later.

Jackson emphasizes how, in addition to his physical symptoms, this patient was burdened by worry for his family. As the primary breadwinner in a family with a 2-year-old daughter, he was stressed about how to continue caring for his family. Moreover, he grappled with a language barrier prevented the patient from understanding the complexity of the treatments that the team was prescribing for him. Therefore, Jacksons’ team had to find innovative ways to ensure that the patient, and his family, felt well supported throughout his treatment.

“The biggest challenge we had was [ensuring] his understanding of how sick he really was, the complexity of the treatment, and that he wouldn’t be able to go back to work right away,” she says.

Episode Notes:

This was a 29 year old male that was diagnosed with Philadelphia chromosome–negative ALL. Time stamp TS 2:13
Given that it’s a clinical trial [product], we don’t always know [what to expect]. We know with the FDA approved products, the 2 biggest factors we need to monitor patients for is cytokine release syndrome and neurotoxicity. These were the things we were watching for. TS 5:38

We did a lot of work with our social worker, he was Mixteca Alto, an indigenous population within the Mexican community, and we wanted to make sure we had the appropriate interpreters. TS 8:09

The Vitals Podcast:

• ASH Data Offer Treatment Direction for Oncology Nursing Professionals
• Oncology Nursing Stories: Acupuncture Helps Thyroid Cancer Survivor Taper Opioid Use
• Oncology Nursing Stories: Pregnancy After Lymphoma Chemoradiation

Oncology Nursing News® Online Articles

• Blinatumomab Plus Consolidation Chemotherapy Significantly Reduces Risk of Death in MRD-Negative B-Cell ALL
• FDA Approves Blinatumomab for Patients with Acute Lymphoblastic Leukemia and Minimal Residual Disease
• The Shifting Dynamics of Social Support After a Cancer Diagnosis

Video Interview
Verina on Tackling Neurological Toxicities From CAR T-Cell Therapy * Expert Weighs in on Future of CAR T-Cell Therapy Treatment Directions*

Oncology Nursing News® Publication Features

• Preparing Patients for CAR T-Cell Therapy With Confidence
• The Future of CAR T-Cell Therapy: Will Off-the-Shelf Options Soon Enter the Playing Field?
• Navigator Offers Strategies to Support Non-English Speaking Patients

References Stock W, Luger SM, Advani AS, et al. A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403. Blood*. 2019;133(14):1548-1559. doi:10.1182/blood-2018-10-881961 * Phase 1/2 study of UCART22 in patients with relapsed or refractory CD22+ B-cell acute lymphoblastic leukemia (BALLI-01). ClinicalTrials.gov. Updated September 27, 2022. Accessed March 3, 2023. https://clinicaltrials.gov/ct2/show/NCT04150497

View Details

Data presented during the 2023 Gastrointestinal Cancers Symposium have accentuated the amount of ongoing research across many of these hard-to-treat gastrointestinal malignancies, according to Terri Pollack, DNP, APRN, FNP-C, PMHNP-BC. Specifically, data surrounding the utility of circulating tumor DNA (ctDNA) should be exciting for RNs and nurse practitioners alike, as it allows providers and patients to visualize if a treatment is working long before a traditional test would show.
Pollack is a nurse practitioner with the Gastrointestinal Cancer Site Disease Group in the Department of Medical Oncology at the University of Miami Sylvester Comprehensive Cancer Center. For this episode of The Vitals, she discusses key data presented during the GI Cancers Symposium. Besides promising data with ctDNA, she also discusses data from the phase 3 SUNLIGHT trial (NCT04737187), which showed that adding bevacizumab (Avastin) to trifluridine/tipiracil (Lonsurf) improved overall survival in patients with refractory metastatic colorectal cancer (mCRC) and the phase 3 BREAKWATER study (NCT04607421), which is assessing encorafenib (Braftovi) plus cetuximab (Erbitux) along with chemotherapy for patients with BRAF V600E–mutant mCRC.

“Great things are coming,” she told Oncology Nursing News®.

Episode Notes:
“For those individuals and their families that understand what we've explained about [ctDNA]; it's really exciting” Time stamp TS 5:50
“From a clinical perspective, we can utilize the data from the ctDNA results to sort of overshadow a scan that we might not see anything yet. It’s just this other tool in the toolbox. I feel like it's maybe going to be like a power drill instead of a little screwdriver.” TS 6:54

“Three point three months in median overall survival really can mean a lot to an individual challenged with this type of cancer and their family.” TS 10:51

The Vitals Podcast
Targeting KRAS Mutations in Gastrointestinal Oncology * Overcome Screening Barriers in CRC*

Oncology Nursing News® Online Articles

• ctDNA Makes Headway as Promising Marker for Patients With Anal Cancer and Other GI Malignancies
• Trifluridine/Tipiracil Plus Bevacizumab Improves OS in Refractory Metastatic
• Encorafenib Triplet Elicits Antitumor Activity in BRAF V600E+ mCRC
• Switch Maintenance Regimens Demonstrate Similar Efficacy for Patients with RAS Wild-Type mCRC

Video Interviews
Kelley Rone on the Evolving Role of Immunotherapy in GI Cancers * Zev Wainberg on Combination Chemotherapy Regimens in Metastatic Pancreatic Cancer*

References
Alvarez J, Cercek A, Mohan N, et al. Circulating tumor DNA (ctDNA) for response assessment in patients with anal cancer treated with definitive chemoradiation. J Clin Oncol. 2023;41(suppl 4):1. doi:10.1200/JCO.2023.41.4_suppl.1 * Tabernero J, Prager GW, Fakih M, et al. Trifluridine/tipiracil plus bevacizumab for third-line treatment of refractory metastatic colorectal cancer: the phase 3 randomized SUNLIGHT study. J Clin Oncol. 2023;41(suppl 4):4. doi:10.1200/JCO.2023.41.4_suppl.4 * Kopetz S, Yoshino T, Kim T, et al. BREAKWATER safety lead-in (SLI): encorafenib (E) + cetuximab (C) + chemotherapy for BRAFV600E metastatic colorectal cancer (mCRC). J Clin Onco*l. 2023;41(suppl 4):119. doi:10.1200/JCO.2023.41.4_suppl.119 * FDA approves encorafenib in combination with cetuximab for metastatic colorectal cancer with a BRAF V600E mutation. FDA. Updated April 9, 2020. Accessed February 23, 2023. bit.ly/3KysLlt

View Details

Knowing a patient’s baseline performance are critical to effectively recognize and respond to toxicities with CAR-T cell therapy, according to Jacqueline T. Norrell, FNP-BC.

Norrell, who is an advanced practice nurse and the director of nursing clinical informatics at Rutgers Cancer Institute, recently sat down with Oncology Nursing News® to discuss her experience helping a patient with refractory diffuse large B-cell lymphoma (DLBCL) navigate treatment with axicabtagene ciloleucel (Yescarta; Axi-cel). Aged 58 years, the male patient had undergone prior therapies before transitioning to CAR T-cell therapy, and developed cytokine release syndrome (CRS) during the course of his treatment. During the discussion, Norrell outlined how the nursing team at her institution helped this patient manage this toxicity and ultimately transitioned them to long-term follow-up care.

The FDA approved axi-cel for adult patients with large B-cell lymphoma (LBCL) and whose disease is refractory to first-line chemoimmunotherapy or relapses within 12 months of first-line chemoimmunotherapy in April, 2022. The approval was supported by findings from the phase 3 ZUMA-7 trial, which showed that at a median follow-up of 24.9 months, the estimated median event-free survival with the therapy was 8.3 months (95% CI, 4.5-15.8) vs 2.0 months (95% CI, 1.6-2.8) with standard-of-care treatment (HR, 0.40; 95% CI, 0.31-0.51; P < .0001).

The prescribing information comes with warnings for CRS and neurologic toxicities. Providers are advised to manage CRS with tocilizumab (Actemra), along with corticosteroids as needed.

Episode Notes:

“One of the components in the assessment and evaluation of patients receiving CAR T—long before the either the hospital administration, infusion or the outpatient care—is the involvement of [a] multi-interdisciplinary team.” Time stamp TS 5:06

“What they described in the presentation of their symptoms was that they had loads of difficulty breathing, had become more fatigued, and they were weak.” TS 9:13

“Know your patient. What’s the patient's baseline? Who do they have at home? What are they expecting [from treatment]?” TS 12:44
The Vitals Podcast:
· ASH Data Offer Treatment Direction for Oncology Nursing Professionals· Ask The Right Questions: Clinical Pearls of AE Management
Oncology Nursing News® Online Articles
· Real-World Patient-Reported Outcomes for Axi-Cel Align With Clinical Trial QOL, Symptomology Data· Axi-cel Sustains Long-Term Survival Rates in Relapsed/Refractory Large B-Cell Lymphoma· New Toxicity Grading Criteria Help Standardize Management of CAR T-Cell Therapy-Related AEs· Early Steroid Use Reduces Cytokine Release Syndrome Risk With Axi-Cel TreatmentVideo Interviews
· Galinsky Breaks Down Venetoclax Symptom Management in AML· Laura Zitella on Third-Line Treatment Considerations in Diffuse Large B-Cell LymphomaOncology Nursing News® Publication Features
· Preparing Patients for CAR T-Cell Therapy With Confidence
· Caring for a Patient With Relapsed Mantle Cell Lymphoma Undergoing CAR T-Cell Therapy· Neurotoxicity With Cilta-cel: Early Intervention Can Improve Outcomes in R/R Myeloma· Revolutionizing Oncology With CAR T-Cell TherapyReference

1. FDA approves axicabtagene ciloleucel for second-line treatment of large B-cell lymphoma. News release. FDA; April 1, 2022. Accessed February 21, 2023. https://www.fda.gov/drugs/

2. Yescarta. Prescribing information. Kite Pharma; 2022. Accessed February 21, 2022. https://www.gilead.com/-/media/files/pdfs/medicines/oncology

View Details

In this episode of The Vitals, Nilesh Kalariya, PhD, AGPCNP-BC, AOCNP; and Laura J. Zitella, MS, RN, ACNP-BC, AOCN, discuss data from the 64th American Society of Hematology Annual Meeting and Exposition that have the greatest potential to change oncology nursing practice.

Kalariya, a nurse practitioner with the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, recently spoke with Oncology Nursing News® highlighted research from the University of Pennsylvania which showed clinical utility of a frailty phenotype tool and contextualized the role of CAR T-cell therapy for patients with multiple myeloma. He also discussed whether data from a subgroup analysis of patients with multiple myeloma who received the anti-BCMA CAR T-cell therapy in the KarMMa-2 trial (NCT03601078) supports moving it forward in the treatment lineup.

Zitella, a nurse practitioner in the Department of Hematology, Blood & Marrow Transplant, and Cellular Therapies Program at the UCSF Helen Diller Family Comprehensive Cancer Center and an associate clinical professor with the School of Nursing University of California, San Francisco, also spoke with Oncology Nursing News®, highlighting exciting advances with BTK inhibitors and how nurses can promote safe eating habits after data from ASH demonstrated that the neutropenic diet does not benefit patients. on which data from the 2022 ASH meeting might have the greatest impact on nurses working in hematologic oncology.

Interested in learning more from ASH? Check out our coverage of the 2022 ASH Meeting here.

We want to hear from you! Which ASH data do you think will be practice-changing? Email lfischer@mjhlifesciences.com with your feedback.

Episode Notes:

“This study that came out at ASH in a transplant population, which is the most immunocompromised population really highlights the [neutropenic diet] and brings it front and center. Hopefully, this will be enough to convince people to abandon the neutropenic diet.” Time stamp (TS) 3:25

“What we see here is that CAR T-cell therapy, followed by maintenance therapy might be a key in frontline settings to have a longer duration of response.” TS 8:30.
“For relapsed or refractory chronic lymphocytic leukemia, zanubrutinib [Brukinsa] had a better overall response rate and progression-free survival than ibrutinib [Imbruvica].” TS 10:19

The Vitals Podcast:

· Stephanie Jackson Unpacks Recent Advances in Leukemia Treatments

· Cardiac Complications in Blood Cancers

Oncology Nursing News® Online Articles

· FDA Grants Pirtobrutinib Accelerated Approval for Relapsed/Refractory MCL

· Noncovalent BTK Inhibitors May Fill Unmet Needs in CLL and Other Top ASH Takeaways

· Optimizing Frailty Tools Are A Vital Component of Improving Care Across Hematologic Malignancies

· Phase 3 Data Support Leaving the “Neutrodiet” Behind After Stem Cell Transplant

· Induction and Maintenance With Ibrutinib Proves Effective for Mantle Cell Lymphoma

· Zanubrutinib Outperforms Ibrutinib in Head-to-Head Trial for Relapsed/Refractory CLL/SLL

Video Interviews

Aaron Gerds on JAK Inhibitor Therapy for Anemic Patients With Myelofibrosis

References
1. Gardner A, Mattiuzzi G, Faderl S, et al. Randomized comparison of cooked and noncooked diets in patients undergoing remission induction therapy for acute myeloid leukemia. J Clin Oncol. 2008;26(35):5684-5688. doi:10.1200/JCO.2008.16.4681 2. Usmani S, Patel K, Hari P, et al. KarMMa-2 cohort 2a: efficacy and safety of idecabtagene vicleucel in clinical high-risk multiple myeloma patients with early relapse after frontline autologous stem cell transplantation. Blood. 2022;140(suppl 1):875-877. doi:10.1182/blood-2022-162469 3. Dhodapkar M, Alsina M, Berdeja J, et al. KarMMa-2 cohort 2c: efficacy and safety of idecabtagene vicleucel in patients with clinical high-risk multiple myeloma due to inadequate response to frontline autologous stem cell transplantation. Blood. 2022;140 (suppl 1):7441–7443. doi:10.1182/blood-2022-162615 4. Stella F, Marasco V, Levati GV, et al. Non-restrictive diet does not increase infections in patients with neutropenia after stem cell transplantation: final analysis of the Neutrodiet multicenter, randomized trial. Presented at ASH 2022. December 10-13, 2022. Abstract 169. 5. Brown JR, Eichhorst B, Hillmen P, et al. Zanubrutinib or Ibrutinib in Relapsed or Refractory Chronic Lymphocytic Leukemia. N Engl J Med. Published online December 13, 2022. doi:10.1056/NEJMoa2211582 6. Mato AR, Woyach, JA, Brown, JR, et al. Efficacy of pirtobrutinib in covalent BTK-Inhibitor pre-treated relapsed / refractory CLL/SLL: additional patients and extended follow-up from the phase 1/2 BRUIN study. Blood. 2022;140(suppl 1):2316-2360. doi.org/10.1182/blood-2022-159497 7. Dreyling M, Doorduijn, JK,Gine E, et al. Efficacy and safety of ibrutinib combined with standard first-line treatment or as substitute for autologous stem cell transplantation in younger patients with mantle cell lymphoma: results from the randomized triangle trial by the european MCL network. Blood. 2022;140(suppl 1):1-3. doi.org/10.1182/blood-2022-163018

View Details

In this episode of The Vitals, we interview 2 nurse practitioners about their key takeaways from the 2022 San Antonio Breast Cancer Symposium (SABCS).
“As time goes [on], we learn more,” says Loyda Braithwaite, MSN, RN, AGPCNP-BC, AOCN. Specifically, as more safety data with fam-trastuzumab deruxtecan-nxki (Enerhtu) comes to light, providers are getting a better idea of how to anticipate and handle potentially serious adverse events such as interstitial lung disease and left ventricular dysfunction. Braithwaite, who is an oncology nurse practitioner at the University of Wisconsin Carbone Cancer Center in Madison, highlights exciting developments in HER2-positive breast cancer and for patients with metastatic disease, as well as the potential benefit of oral selective estrogen receptors degraders, throughout the discussion.
Moreover, according to Jamie Carroll, APRN, CNP, MSN, a nurse practitioner at Mayo Clinic in Rochester, Minnesota, data presented at the meeting may change patient conversations in the adjuvant setting. Findings from the POSITIVE (NCT02308085) trial suggest that pausing adjuvant endocrine therapy may be safe for women with hormone receptor–positive breast cancer who wish to pursue pregnancy.
“It's a common discussion that we have and it’s helpful to know that the POSITIVE trial did not see that disrupting endocrine therapy impacted disease outcomes,” Carroll says. “That’s helpful for patients and providers to know that they’re not seeing an increase in recurrence when endocrine therapy is paused to achieve pregnancy.”
Interested in learning more from SABCS? Check out our coverage of the conference here.
We want to hear from you! Which data from SABCS do you think will be practice changing? Email lfischer@mjhlifesciences.com with your feedback.
The Vitals Podcast:
· Sarah Donahue Highlights Destiny-Breast04 Trial Takeaways for Patients With HR+, HER2-Low Metastatic Breast Cancer
· Sri Kota Weighs in On the Evolving Breast Cancer Paradigm

Oncology Nursing News® Online Articles
· Emerging Data Showcases Promising Advancements for Patients With HER2-Low Breast Cancer
· POSITIVE Study Findings Shift Conversations on Pregnancy in ER+ Breast Cancer
· CBD Oil Shows Modest Improvements in Tamoxifen-Related Adverse Effects
· Antidiarrheal Prophylaxis Remains a Key Focus in TKI Treatment for Patients with HER2+ Breast Cancer
· Real-World Data Show Neoadjuvant Pertuzumab/Trastuzumab Increases pCR Rates in HER2+ Breast Cancer

Video Interviews
Grace Choong and Matthew Goetz On the Impact of Adjuvant Endocrine Therapy Omission in ER+ Positive Breast Cancer

References
· Hurvitz SA, Hegg R, Chung WP, et al. Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: Updated survival results of the randomized, phase 3 study DESTINY-Breast03. Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.
· Krop, Ian et al T-DXd yields superior outcomes over chemotherapy-based regimens in patients previously treated with T-DM1 participating in the phase III DESTINY-Breast02 trial. Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.
· Rugo HS, Bardia A, Marmé F, et al. Sacituzumab govitecan vs treatment of physician’s choice: efficacy by Trop-2 expression in the TROPiCS-02 study of patients with HR+/HER2– metastatic breast cancer. Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.
· Hurvitz S, Wang LS, McAndrew NP, et al. TRIO-US B-12 TALENT: neoadjuvant trastuzumab deruxtecan (T-DXd) with or without anastrozole for HER2-low, HR+ early-stage breast cancer. Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.
· Bardia A, Bidard FC, Neven P, et al. EMERALD phase 3 trial of elacestrant versus standard of care endocrine therapy in patients with ER+/HER2- metastatic breast cancer: updated results by duration of prior CDK4/6i in metastatic setting. Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.
· Partridge A, Niman SM, Ruggeri M, et al. Pregnancy outcome and safety of interrupting therapy for women with endocrine responsIVE breast cancer: primary results from the POSITIVE trial (IBCSG 48-14 / BIG 8-13). Presented at: 2022 San Antonio Breast Cancer Symposium; December 6-10, 2022; San Antonio, TX.

View Details

In this special episode of “The Vitals,” we ring in the New Year by combing through 2022 FDA approvals. Listen as associate editor, Lindsay Fischer, recounts key approvals on a month-by-month basis, with input from some of the investigators from behind the research. To read the full information surrounding the approvals, be sure to check out our news coverage below. Other resources can also be found below.
As always, thank you for listening to The Vitals, and for all the engagement in 2022. We look forward to bringing you more oncology news in 2023.
We want to hear from you! Which drugs approved in 2022 have been practice changing? Have you had any difficulty or success in incorporating these novel agents into clinical use? Any challenges with supporting patients on these regimens? Email lfischer@mjhlifesciences.com with your feedback
References
January
FDA Approves Tebentafusp to Treat HLA-A02:01 Positive Uveal Melanoma

February
* Cilta-Cel Snags FDA Approval for Relapsed/Refractory Multiple Myeloma

March
* Neoadjuvant Nivolumab Plus Platinum-Doublet Chemotherapy Is Now Approved for Resectable NSCLC * FDA Greenlights Olaparib for BRCA-Mutated, HER2-Negative Breast Cancer * FDA OKs Relatlimab/Nivolumab for Unresectable or Metastatic Melanoma * FDA Approves Pembrolizumab in MSI H/dMMR Advanced Endometrial Carcinoma * FDA Approves 177Lu-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer

April
* Axi-Cel Snags FDA Approval for Second-Line LBCL

May
* FDA Approves Trastuzumab Deruxtecan for Unresectable or Metastatic HER2+ Breast Cancer * FDA Grants Ivosidenib Plus Azacitidine Approval for Newly Diagnosed AML With IDH1 Mutations * FDA Grants Azacitidine Approval For Pediatric Patients With Myelomonocytic Leukemia * FDA Grants 2 Frontline Nivolumab-Based Regimens Approval for Unresectable Advanced or Metastatic ESCC * Tisagenlecleucel Receives FDA Approval for Relapsed or Refractory Follicular Lymphoma

June

• FDA Grants Accelerated Approval to Dabrafenib Plus Trametinib for BRAF V600E–Mutated Solid Tumors
• FDA Approves Liso-Cel for Second-Line Large B-Cell Lymphoma

July
* Crizotinib Approved For ALK+ Inflammatory Myofibroblastic Tumors

August
* HER2-Directed Therapy, Trastuzumab Deruxtecan, Approved for Metastatic NSCLC * Trastuzumab Deruxtecan Is Approved for Patients With Metastatic HER2-Low Breast Cancer * FDA Approves Darolutamide Tablets for Select Patients With Prostate Cancer * Capmatinib Snags Full FDA Approval for MET Exon 14 Skipping NSCLC * FDA Grants Ibrutinib Approval for Pediatric Graft-Versus-Host-Disease * FDA Gives Pemigatinib Greenlight for FGFR1 Rearranged Myeloid/Lymphoid Neoplasms

September
* Durvalumab Plus Gemcitabine/Cisplatin Approved by the FDA for Advanced or Metastatic Biliary Tract Cancers * Sodium Thiosulfate Gets Green Light for Chemotherapy-Induced Hearing Loss in Pediatric Patients * Selpercatinib Is Approved for 2 RET Fusion–Positive Solid Tumors, Non–Small Cell Lung Cancer * FDA Approves Futibatinib for Pretreated, Advanced or Metastatic Intrahepatic Cholangiocarcinoma with FGFR2 Rearrangements

October
* FDA Approves Durvalumab in Combination with Tremelimumab for Unresectable HCC * Teclistamab-cqyv Snags Accelerated Approval for Relapsed or Refractory Multiple Myeloma

November
* Cemiplimab Gets Go Ahead In Combination With Chemotherapy For Advanced NSCLC * Brentuximab Vedotin Gets Green Light for High-Risk Hodgkin Lymphoma in Pediatric Patients * Durvalumab/Tremelimumab/Chemotherapy Combination Approved for NSCLC Indication * Mirvetuximab Soravtansine-gynx Gets Go Ahead in Platinum-Resistant Ovarian Cancer

December
* Olutasidenib Approved for IDH1-Mutated Acute Myeloid Leukemia * Adagrasib Receives Accelerated Approval for KRAS G12C Mutated NSCLC

Additional Resources:
Videos
* Watch: Newly Approved Tebentafusp Requires Up-Front Active Toxicity Management in Melanoma * Dr. Geyer Highlights Optimal Dosing Strategies for New Olaparib Indication in Breast Cancer * Nurse Takeaways: Latest Pembrolizumab Indication in Endometrial Cancer

Oncology Nursing News® Online Articles
* Podsada Discusses Biomarker Testing and ADC Therapies in Breast Cancer * Goodwin Provides Nursing Perspective on Recent FDA Approvals in NSCLC * Futibatinib Approval Ushers in Targeted Therapy Option for Patients With Unresectable, Intrahepatic FGFR2-Positive Cholangiocarcinoma * Barber Discusses the Integration of Durvalumab/Chemotherapy Combination as New Standard of Care in Biliary Tract Cancers

The Vitals Podcast:
* Listen: Stephanie Jackson Unpacks Recent Advances in Leukemia Treatments * Listen: Sarah Donahue Highlights Destiny-Breast04 Trial Takeaways for Patients With HR+, HER2-Low Metastatic Breast Cancer

View Details

Complementary therapies, such as acupuncture, can deliver significant benefits when used in combination with standard therapies, according to Heather Jackson, PhD, FNP-BC, NEA-BC, FAANP.
In this episode of The Vitals, Jackson, who is administrative director of advanced practice at Vanderbilt University Medical Center, Vanderbilt Ingram Cancer Center, discusses how complementary acupuncture helped one thyroid cancer survivor achieve his goal of stopping opioid use to manage his cancer-related pain. Throughout the discussion, she highlights common questions patients have about acupuncture, what different forms of treatment are available, and how providers can assess the efficacy of the integrative therapy.
“My advice would be to always consider [acupuncture] as an adjunct [option],” Jackson says. “There is a lot of miscommunication sometimes with complementary therapies, [where] people will assume that’s the only option. That’s not what we’re saying. When we say complementary, we [mean] in addition to.”
Episode Notes:
“He was still having a lot of facial pain [in] his left cheek and neck and TMJ [temporomandibular joint dysfunction] pain. He had been taking oxycodone—15 mg 4 times a day but he came to me and said, ‘I’m a father, I’m a husband. And it’s really sedating for me. I can’t sit down at meals, I can’t enjoy social activities, anything I do is uncomfortable.’ ” Time stamp TS 02:19
“I looked at his medicine regimen and I said, ‘Well, it’s not the cure all. But I think it could be a piece of the pie.’ When we think about treating pain, if you’re going to treat the whole person, you have to think about all the different aspects of the person.” TS 03:09
“The acupuncture that we do in our clinic is a modified acupuncture technique. It’s not full body, it’s limited to the ear. They call it auricular acupuncture.” TS 05:19
“He’s actually not in my clinic anymore because we got him off of everything. I think he just needed help getting through that period of getting off the medicine.” TS 12:10
The Vitals Podcast:
Behind Integrated Behavioral Health Services * Ask The Right Questions: Clinical Pearls of AE Management*

Oncology Nursing News® Online Articles
Acupuncture Reduces Joint Pain from Aromatase Inhibitors * Study Examines Cost, Efficacy of Group Acupuncture for Patients With Breast Cancer * Acupuncture Offers Quality-of-Life Benefits for Patients Taking AIs*

Video Interviews

• Rebecca Lehto on Complementary Modalities During Lung Cancer Treatment
• Uri Goldberg Outlines Steps For Improving Pain Management

Oncology Nursing News® Publication Features
* Helping Patients Navigate Complementary Treatments * Open Discussions Help Nurses Introduce Integrative Services * Spotlight on Integrative Oncology Navigation * Complementary Therapies for Prostate Cancer Treatment

References
Jackson HJ, Peal K. Auricular acupuncture for the treatment of cancer-related pain. Oncology Issues.2022;37(4):32-35. doi:10.1080/10463356.2022.2079353
Jackson HJ, Walters J, Raman R. Auricular acupuncture to facilitate outpatient opioid weaning: a randomized pilot study. Med Acupunct. 2021;33(2):153-158. doi:10.1089/acu.2020.1450
Jackson HJ, López C, Miller S, Englehardt B. Neonatal abstinence syndrome: an integrative review of neonatal acupuncture to inform a protocol for adjunctive treatment. Adv Neonatal Care. 2019;19(3):165-178. doi:10.1097/ANC.0000000000000630
Jackson HJ, Lopez C, Miller S, Engelhardt B. A acoping review of acupuncture as a potential intervention for neonatal abstinence syndrome. Med Acupunct. 2019;31(2):69-84. doi:10.1089/acu.2018.1323
Jackson HJ, Lopez C, Miller S, Englehardt B. Feasibility of auricular acupressure as an adjunct treatment for neonatal opioid withdrawal syndrome (NOWS). Subst Abus. 2021;42(3):348-357. doi:10.1080/08897077.2020.1784360
Jackson HJ, Reneau MG, Hande K. A scoping review of measures utilized to assess patient satisfaction with acupuncture treatments within randomized controlled trials. Med Acupunct. 2022;34(5):308-315. doi:10.1089/acu.2022.0015

View Details

For this episode of The Vitals, Oncology Nursing News® speaks with Aliènne Salleroli, MS, BSN, RN, OCN, an assistant patient services manager at Yale-New Haven Health Smilow Cancer Hospital, and cochair of the Yale New Haven Hospital Diversity, Equity, and Inclusion Nursing Task Force. Earlier this year, Salleroli presented research on how racial diversity within oncology nursing is not enough to create lasting change—there needs to also be racial diversity within oncology nursing leadership to inspire positive outcomes. However, when it comes to making change on an individual level, the best thing that an oncology nurse leader can do is help initiate dialogue.
“We need to walk before we can run,” says Salleroli. “Before we start these enormous interventions, which are wonderful, we really need to lay down this foundation to put down some groundwork by making [equity, diversity, and inclusion] a part of everything that we do.”

Episode Highlights
“The results were quite interesting because they were not what I expected them to be: diversity alone will not increase positive outcomes. There also needed to be strong leadership as well [and] there needs to be a unified vision within the organization that will help support these changes and support diversity as well.” Time stamp (TS) 02:02
“changing the paradigm of how we envision diversity was equally as important as how we implement the interventions themselves.” TS 02:24
“it's important for other nurses not only just to see that representation, but to have that representation, [this means] being able to create policies and interventions that are that directly impact nurses of color as well.” TS 04:40
“Diversity, equity inclusion should be thought of like quality and safety. It should stand alone on its own, but yet, every nurse should always have quality and safety on their mind with every single intervention that they do, they should always be thinking about quality and safety.” TS 10:53
“Systemic racism is a huge problem and a national health crisis. It is no different in oncology. We need to make sure that all of our bases are covered— that we view this with just as much importance as everything else that we do.” TS 13:51
The Vitals Podcast:
Championing Diversity in Nursing and Oncology*

Oncology Nursing News® Online Articles
The Future of Nursing Must Be Diverse * Diversity and Inclusion Should be Valued in Leadership Roles * The Role of Case Management: Improving Outcomes and Addressing Health Disparities in Cancer Care * Fostering Exceptional Nursing Leadership*

Oncology Nursing News® Publication Features

• Nurses Must Adapt to Meet the Needs of a Diverse Patient Population

Video Interviews
Starting the DEI Conversation in Oncology Nursing * Establishing Equity, Diversity, and Inclusion Throughout Oncology Practice*

References
Salleroli A. Racial Diversity Within Oncology Healthcare Leadership Increases Positive Outcomes. Presented at: 47th Annual Oncology Nursing Society Congress; April 27-May 1, 2022; Anaheim, CA. Abstract P161.
Dotson E, Nuru-Jeter A. Setting the stage for a business case for leadership diversity in healthcare: history, research, and leverage. J Healthc Manag. 2012;57(1):35-46; discussion 45-46.

View Details

In this episode of The Vitals, Ellen Miller, MSN, FNP-BC, a nurse practitioner with Vanderbilt University’s Radiation Oncology Survivorship Clinic, shares her experience with a 26-year-old woman who wanted to get pregnant after undergoing chemoradiation for stage II extranodal natural killer T-cell lymphoma of the nasal cavity as a teenager. Miller underscores why some patients may not choose or be able to pursue fertility preservation when they receive a cancer diagnosis, and what follow-up conversations might be necessary for survivors who have family building goals following cancer treatment.

References and resources are provided below.Episode Highlights

“When I talked with her, I asked her, specifically, ‘Were you offered fertility preservation?’ And she said, ‘Absolutely.’ [But] she declined, she said, ‘I was 19, I didn’t think I wanted kids.’ But she had [since] met her husband, a wonderful man, and decided that she wanted to have kids.” Time Stamp (TS) 05:29

“The out-of-pocket [cost] for fertility preservation is $10,000 to $15,000, on average. That’s hard for [anyone], not to mention a young [woman].” TS 06:26

“Not only can chemotherapy damage existing eggs, but it can also lead patients to have early or premature menopause.” TS 09:16

“If patients were to have left-sided chest radiation, [for] a lymphoma or maybe even a breast cancer, we would do some cardiac monitoring, since both the chemotherapy and the radiation can be damaging to the heart, and pregnancy can cause the heart to work harder.” TS 12:16

“[The] trajectory for her experience was pretty standard, and we were thankful for that. But there are some reasons why some women would need further monitoring.” **TS 15:41

Episode Notes**

The Vitals Podcast:

• Improving Onco-Fertility Conversations With Adolescents and Young Adult Patients With Cancer

Oncology Nursing News® Online Articles

• Fertility and Family Planning: Supportive Patient Conversations
• Quality Oncology Care: Discussing Fertility Preservation for Patients With Breast Cancer
• Fertility Preservation Guidelines Urge for Early Discussions With Young Patients with Cancer

Video Interviews

• Jennifer Levine on Fertility Challenges in Survivors of Childhood Cancer
• Gwendolyn Quinn Discusses Fertility Concerns in Childhood Cancer Survivors

Oncology Nursing News® Publication Features

• Let's Talk About Sex, Fertility, and Intimacy After Cancer
• Adolescent and Young Adult Patients Face Unique Needs, Challenges
• Is Chemotherapy an Emergency When Fertility Is at Risk?

References * Female reproductive health. CureSearch for Children’s Cancer. Accessed November 15, 2022. https://bit.ly/3UP7XIe * Having a baby after cancer: pregnancy. American Cancer Society. March 2019. Accessed November 15, 2022. https://bit.ly/3EdKQjM * Fertility facts. Leukemia & Lymphoma Society. November 2014. Accessed November 15, 2022. https://bit.ly/3EdLaiu * Quick guide to fertility preservation. July 2022. Accessed November 15, 2022. https://bit.ly/3GgnbSz * Cardonick EH. Overview of infertility and pregnancy outcome in cancer survivors. UpToDate. July 24, 2019. Accessed November 15, 2022. https://bit.ly/3ty7iiM

Resources

• Livestrong Fertility
• The Oncofertility Consortium
• VERNA’S PURSE
• the samfund

View Details

For this episode of The Vitals, Oncology Nursing News® spoke withJeannette Meyer, MSN, RN, CCRN-K, CCNS, PCCN-K, ACHPN, a palliative care clinical nurse specialist with UCLA Health about the value of advance directives for vulnerable populations. Meyer highlights her personal experience working with unhoused populations near and around Los Angeles, California. Meyer works with programs including “Hearing Their Voice” and “Hospice Under the Bridge,” which seek to help homeless patients connect with much needed medical resources and help providers understand the personal health goals of individual patients who may one day present in the hospital.

Episode Highlights

“Our homeless patients are dying of the same things that we are all dying of… they have cardiac disease, they have cancer, they have liver failure, they have pulmonary disease.” Time stamp [TS] 5:07

“We wanted to figure out a way to hear their voice. To honor them. To respect what they would want for their health care and their choices.” TS 8:39

“Whenever we ask these people, not just “how would you want to live?” but “how would you want to die?” They are asking—most of the time—for 2 simple things. To be treated with dignity and not to be in pain and suffering.” TS 20:36

“I don't know what your line in the sand is. I don't know what an acceptable quality of life for you is, or what gives you joy or what gives you meaning. But I beg of you to document those things, so that whomever might be making decisions for you will know what you want.” TS 24:14

Episode Notes

The Vitals Podcast: * Using Education to Understand the Realities of Palliative Care * Capturing the Voice of the Child in Cancer Care * How to Create a Welcoming Environment for LGBTQ Patients

Oncology Nursing News® Online Articles

• Personalized Sedation Goals May Help Standardize End-of-Life Care for Patients with Agitated Delirium
• Incorporating Palliative Practices Into Critical Care
• Better End-of-Life Options Are Needed for AYA Patients With Advanced Cancer
• What Oncology Nurses Should Understand About Medical Aid in Dying

Video Interviews * Oncology Nurses Provide Patients an Avenue to Supportive Care

Oncology Nursing News® Publication Features

• End-of-Life Conversations: What Nurses Are Saying
• Oncology Nurses Must Navigate Difficult End-of-Life Discussions

References * Cortez DM, Meyer J. Hearing their voice: advance care planning for the homeless. Crit Care Nurs Clin North Am. 2022;34(1):57-65. doi:10.1016/j.cnc.2021.11.010 * Meyer J. When goals of care are not enough. Coalition for Compassionate Care of California. June 23, 2016. Accessed October 28, 2022. https://bit.ly/3NkCY47

View Details

For this episode of The Vitals, Oncology Nursing News® spoke with Daniel J. Verina, DNP, RN, MSN, ACNP-BC, of the Myeloma Team with Mount Sinai Medical Center, about optimal strategies for adverse event management for patients receiving selinexor (Xpovio). Verina recently presented on adverse event management for novel multiple myeloma therapies as part of the International Myeloma Society’s 6th Annual Nursing Symposium.

Episode Highlights

“I think one of the challenges is when a patient keeps relapsing and [you have] to come back to them and [say] you relapsed again, we have to change your treatment. That is a challenge in all. In all honesty.” Time stamp [TS] 9:04

“Patients tend to become dehydrated: You really want to make sure they have good oral fluid intake, [and] you want to be able to monitor diarrhea.” TS 12:52

“Low sodium was another big side effect that we saw in our patient population… I tell patients to eat salty snacks, which will help with their lack of eating and help with their weight.” TS 15:24

“One of my educational points with patients is that you want to be able to weigh yourself every day, at the same time, with the caregiver with them, to make sure that they're maintaining their same weight.” TS 19:01

“We always have a nutritionist jump in right away with our patients that start on selinexor to try to find the best nutritional support whether it's high calories and small packages be able to give those to patients up front so they can maintain their weight.” TS 19:14

Episode Notes

The Vitals Podcast:

· Ask The Right Questions: Clinical Pearls of AE Management

· Cardiac Complications in Blood Cancers

Oncology Nursing News® Online Articles

· Verina Underscores Best Nursing Practices With Targeted Therapies in Multiple Myeloma

· FDA Approves Selinexor Combination for Pretreated Patients with Myeloma

· FDA Approves Selinexor for Relapsed/Refractory Myeloma

· Myeloma Treatment Landscape Continues to Change

Video Interviews

· Nursing Considerations for Using Selinexor in Multiple Myeloma

Oncology Nursing News® Publication Features

· Living With Multiple Myeloma: Nurses as the Lifeline

References

· Verina DJ. Managing the toxicities associated with newer targeted therapies. Presented at: International Myeloma Society 6th Annual Nursing Symposium; August 25-27, 2022; Los Angeles, CA. NS-001.

· Xpovio. Prescribing information. Karyopharm Therapeutics Inc; 2022. Accessed October 12, 2022. https://bit.ly/3CvLbO3

· Parikh K, Cang S, Sekhri A, Liu D. Selective inhibitors of nuclear export (SINE)—a novel class of anti-cancer agents. J Hematol Oncol. 2014;7:78. doi:10.1186/s13045-014-0078-0

· Gupta A, Saltarski JM, White MA, Scaglioni PP, Gerber DE. Therapeutic targeting of nuclear export inhibition in lung cancer. J Thorac Oncol. 2017;12(9):1446-1450. doi:10.1016/j.jtho.2017.06.013

· Gavariatopoulou M, Chari A, Chen C, et al. Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials. Leukemia. 2020;34(9):2430-2440. doi:10.1038/s41375-020-0756-6

· Common terminology criteria for adverse events, version 5.0. National Institutes of Health, National Cancer Institute. Published November 27, 2017. Accessed October 17, 2022. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf

· Mikhael J, Noonan KR, Faiman B, et al. Consensus recommendations for the clinical management of patients with multiple myeloma treated with selinexor. Clin Lymphoma Myeloma Leuk. 2020;20(6):351-357. doi:10.1016/j.clml.2019.12.026

· Magen H, Geva M, Volchik Y, Avigdor A, Nagler A. Selinexor, bortezomib, and dexamethasone for heavily pretreated multiple myeloma: a case series. Clin Lymphoma Myeloma Leuk. 2020;20(12):e947-e955. doi:10.1016/j.clml.2020.07.016

View Details

For this episode of The Vitals, Oncology Nursing News® spoke with Milagros Elia, MA, APRN, ANP-BC, about the role that oncology nurses play in increasing dialogue around climate change. Elia recently presented on climate change as part of the 2022 Oncology Nursing Society Bridge. In this episode, she discusses how increases in heat and poor air quality can negatively affect vulnerable populations, and the role nurses play in proactively managing their patients’ health in the context of changing local climates.

Episode Highlights

Top takeaways from the discussion include:

“We know that climate change is damaging human health today and will have a greater impact in the future. These health consequences will inevitably harm some more than others.” Timestamp (TS) 04:46

“As nurses, we realize that extreme heat can take a toll on the body and increase the risk of heat-related illnesses and hospitalizations.” TS 13:37

“How do we allow for the continuation of care when we have an area that has been flooded? Or [where] wildfires have been?” TS 16:22

“[If] you have patients going undergoing chemotherapy, they are extra sensitive to the sun; they need extra [sun] protection, so you tell them about the EPA’s [Environment Protection Agency] UV index application.” TS 21:07

“You don't need to use the word climate change with [your patients] unless they are open to that conversation. What you need to do is you need to address their symptoms and make the connection to their environment.” TS 22:08

Episode Notes

The Vitals Podcast:

• Episode 27: COVID-19 Pandemic Emphasizes Disparities in Cancer Care
• Episode 10: The Year of the Nurses' Voice

Oncology Nursing News® Online Articles

· Climate Change and Evolving Threats to Public Health: The Oncology Nurse’s Role

· Better Research Funding Practices Are Needed to Mitigate Disparities in Cancer Incidence and Mortality

· Get to the Root of Cancer Disparities

· Sunscreen Guide Contains Surprises About Effectiveness

· Nurse Mentors: We Rise by Lifting Others

Oncology Nursing News® Publication Features

· The Connection Between Lung Cancer and Outdoor Air Pollution

Video Interviews

· Expert Says Pandemic Put a ‘Lens’ on Health Disparities for People Outside the Medical Field

References

• Climate change and health. World Health Organization. October 30, 2021. Accessed September 22, 2022. https://bit.ly/2SXgflM
• Elia MR. Climate change and its impact on health. Presented at: ONS Bridge; September 13-15, 2022; virtual.
• Nogueira LM, Yabroff KR, Bernstein A. Climate change and cancer. CA Cancer J Clin. 2020;70(4):239-244. doi:10.3322/caac.21610
• Walker RK, Pereira-Morales S, Kerr R, Schenk E. Climate change should be on every nursing research agenda. Oncol Nurs Forum. 2020;47(2):135-144. doi:10.1188/20.ONF.135-144
• Butterfield P, Leffers J, Vásquez MD. Nursing’s pivotal role in global climate action. BMJ. 2021;14(373):n1049. doi:10.1136/bmj.n1049. PMCID: PMC8201521.
• Man RX, Lack DA, Wyatt CE, Murray V. The effect of natural disasters on cancer care: a systematic review. Lancet Oncol. 2018;19(9):e482-e499. doi:10.1016/S1470-2045(18)30412-1
• Turner MC, Andersen ZJ, Baccarelli A, et al. Outdoor air pollution and cancer: an overview of the current evidence and public health recommendations. CA Cancer J Clin. 2020;10.3322/caac.21632. doi:10.3322/caac.21632

Thanks again for listening to The Vitals. Be sure to never miss a beat with Oncology Nursing News®.

View Details

For this episode of The Vitals, Oncology Nursing News® spoke with Christine Miaskowski, PhD, RN, professor in the Department of Physiological Nursing and Anesthesia at UCSF School of Nursing. Miaskowski discusses results from research which showcases an increased risk of hearing loss among patients who received platinum- or taxane-based cancer treatments. She also discusses the importance of including hearing assessments as a standard of care for survivors.

Episode Highlights

Top takeaways from the discussion include:

“When we did audio metrically confirmed hearing loss [assessments], we found that between 50% to 70% of survivors had confirmed hearing loss.” Timestamp (TS): 04:29

“It’s really, very surprising because it is a group of patients with very common cancers: breast, lung, gynecologic and GI [gastrointestinal] malignancies.” TS 04:59

“The good news is that the type of hearing loss these patients experience is amenable to a hearing aid. So, if we can get people tested, and they demonstrate this kind of hearing loss, we can improve their quality of life.” TS 06:09

“Nurses care about interactions with other people, people’s quality of life, [their] social function… if you've got hearing loss, and you're sitting at a table with people, and you can't hear them, you're not going to be likely to participate.” TS 06:56

“We don’t even think about [some of] these consequences; in terms of occupation, social gatherings, safety for a child… We really, as nurses, need to be doing something about this.” TS 09:10

Episode NotesThe Vitals Podcast:

• Episode 33: Balancing the Benefit and Toxicity of Cisplatin in Young Children with Cancer
• Episode 45: Key Advances in Cancer Survivorship Toxicity Management

Oncology Nursing News® Online Articles * Audiological Assessments May Be Vital Component of Cancer Survivorship Care Following Chemotherapy * Cisplatin May Cause Ototoxicity * Hearing Loss Found in Testicular Cancer Survivors After Cisplatin Therapy * Genetic Mutation Could Play Role in Cisplatin-Induced Hearing Loss

Oncology Nursing News® Publication Features * Survivors Need Research-Based Interventions and Stronger Coordination Across Care Continuum * What Are the Needs of Cancer Survivors 5 Years or More After Treatment? * Everyone's Business: Taking Survivorship Care to the Next Level

Video Interviews Heather E. Wheeler Discusses Cisplatin-Induced Hearing Loss References * Cheung S, Henderson-Sabes J, Mastick J, et al. Cancer survivors and neurotoxic chemotherapy: hearing loss and tinnitus. BMJ Support Palliat Care. Published online July 27, 2022. doi:10.1136/spcare-2022-003684 * Romano A, Capozza MA, Mastrangelo S, et al. Assessment and management of platinum-related ototoxicity in children treated for cancer. Cancers. 2020;12(5):1266. doi:10.3390/cancers12051266 * Biro K, Noszek L, Prekopp P, et al. Characteristics and risk factors of cisplatin-induced ototoxicity in testicular cancer patients detected by distortion product otoacoustic emission. Oncology. 2006;70(3):177-184. doi:10.1159/000093776 * Cheraghi S, Nikoofar P, Fadavi P, et al. Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy. Med Oncol. 2015;32(7):200. doi:10.1007/s12032-015-0646-3 * Langer T, am Zehnhoff-Dinnesen A, Radtke S, Meitert J, Zolk O. Understanding platinum-induced ototoxicity. Trends Pharmacol Sci. 2013;34(8):458-469. doi:10.1016/j.tips.2013.05.006

View Details

In this episode of The Vitals, a panel of oncology nurses and nurse practitioners with backgrounds in gastric and breast cancer unpack adverse event (AE) management with anti-body drug conjugates (ADCs).

Sarah Donahue, MPH, NP, AOCNP, of the University of California San Francisco Health recently moderated a discussion with Jamie Carroll, APRN, CNP, MSN, of the Mayo Clinical in Rochester Minnesota; Theresa Wicklin Gillespie, PhD, MA, RN, FAAN, of the Winship Cancer Institute with Emory University; and Elizabeth Prechtel-Dunphy, DNP, RN, ANP-BC, AOCN of the Abramson Cancer Center with the University of Pennsylvania. The Peer Exchange program was structured to highlight real-world scenarios to put best nursing practices into context when using approved ADCs in clinic.

Following a case study presented by Gillespie on a woman with metastatic gastric cancer who developed neutropenia while receiving fam-trastuzumab deruxtecan-nxki (Enhertu), the panel discuss the other potential AEs associated with this treatment—including neuropathy, nausea, and interstitial lung disease. They compare the rate of incidences for these AEs between gastric and breast cancers, pose questions regarding the value of interdisciplinary collaboration with pulmonary teams, and pitch questions regarding agent suitability for patients with pre-existing comorbidities.

Basing their conversation around published clinical trial data and experience from their personal practice, they discuss how to best manage these events, wrapping up with clinical pearls for all oncology nurses who care for patients receiving an ADC for metastatic disease.

View Details

For this episode of The Vitals, Oncology Nursing News® met with Stephanie Jackson, DNP, MSN, RN, AOCNP, BMTCN, to discuss key takeaways from her recent presentation at the 6th Annual School of Nursing Oncology™ Meeting. Jackson, who is a certified oncology and bone marrow transplant clinical nurse specialist and unit director at UCLA Medical Center, presented on advances in the treatment of leukemia, and highlighted how nurses can practice at the top of their licensure incorporating the latest advances in hematologic malignancies.

Jackson discusses the clinical application of drugs which were recently added into the treatment schema, such as ivosidenib (Tibsovo) plus azacitidine, which was approved in May 2022 for patients with newly diagnosed IDH1-mutated acute myeloid leukemia (AML) who are aged 75 years or older, or who have comorbidities that preclude use of intensive induction chemotherapy. According to Jackson, differentiation syndrome and QT prolongation are 2 possible adverse events (AEs) associated with this treatment that nurses need to recognize.

She also discusses the evolving role of CAR T-cell therapy in the context of leukemia treatment, including the 2021 approval of brexucabtagene autoleucel (Tecartus) for relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). Jackson highlights the benefits and limitations of this therapy, and offers a perspective on the potential benefit that allogeneic CAR T-cells may bring to the table.

Overall, it is inspiring time to work in leukemia, Jackson says.

“I’m excited about seeing many of my patients living much longer and being able to have treatments like CAR T,” she remarks. “It takes a nurse who is knowledgeable of the drugs, knows the AEs, and who are partnering with the interdisciplinary team to make sure that we can get these patients through this treatment.”

View Details

For this episode of The Vitals, Oncology Nursing News® met with Sarah Donahue, MPH, NP, a nurse practitioner at the University of California San Francisco Health, to discuss findings from the findings of DESTINY-Breast04 trial (NCT03734029).

DESTINY-Breast04, a phase 3, open-label pivotal trial, randomly assigned patients with unresectable or metastatic HER2-low breast cancer to receive the fam-trastuzumab deruxtecan-nxki (Enhertu) at 5.4 mg/kg every 3 weeks (n = 373) or physician’s choice chemotherapy at locally approved dosing (n = 184). All enrolled patients had already received at last 1 prior line of therapy in the metastatic setting.

The primary end point was progression-free survival (PFS) in patients with hormone receptor–positive breast cancer. The median PFS in the primary end point population was 10.1 months (95% CI, 9.5-11.5) with the antibody-drug conjugate vs 5.4 months (95% CI, 4.4-7.1) with standard of care (HR, 0.51; 95% CI, 0.40-0.64; P < .0001). The median overall survival was 23.9 months (95% CI, 20.8-24.8) vs 17.5 months (95% CI, 15.2-22.4), respectively (HR, 0.64; 95% CI, 0.48-0.86; P = .003).

These findings, according to Donahue, will result in the addition of another therapy that patients with unresectable or metastatic HER2-low breast cancer can benefit greatly from.

“One significant part [of] this trial is that included such a large population of patients,” Donahue says. “It really captured most patients with metastatic breast cancer—[there were] patients with liver metastases, lung metastases, and brain metastases that were stable. It really covered a very large representative group of patients.”

Further, Donohue adds, “The data that were presented at the [2022 ASCO Annual Meeting] showed that the patients that received the trials trastuzumab deruxtecan had a much [improved] PFS compared with those patients that were on the physician’s choice of chemotherapy. [Investigators] found that they could increase the median PFS from 5 months to about 10 months, so they could double it,” Donahue explains. “It was similar with the patients with hormone [receptor]–positive diseases, as with the entire population. It did not matter what the hormone receptor status was for these patients, [they all] received that benefit.”

If you liked today’s episode of The Vitals, please consider subscribing to our podcast on Apple Podcasts, Spotify, Google Podcasts, Amazon Music, and many of your other favorite podcast platforms, to get a notification every time a new episode is posted. While you are there, please take a moment to rate us!

Thanks again for listening to The Vitals. Be sure to never miss a beat with Oncology Nursing News®.

References

1. Modi S, Jacot W, Yamashita T, et al. Trastuzumab deruxtecan (T-DXd) versus treatment of physician’s choice (TPC) in patients (pts) with HER2-low unresectable and/or metastatic breast cancer (mBC): results of DESTINY-Breast04, a randomized, phase 3 study. J Clin Oncol. 2022;40(suppl 17):LBA3. doi:10.1200/JCO.2022.40.17_suppl.LBA3
2. Modi S, Jacot W, Yamashita T, et al; DESTINY-Breast04 Trial Investigators. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med. 2022;387(1):9-20. doi:10.1056/NEJMoa2203690

View Details

For this episode of The Vitals, Oncology Nursing News® met with Lidia Schapira, MD, FASCO, to discuss key advances in the treatment of toxicities that may present later in cancer survivorship care. 

Schapira is a professor of medicine and director of the Cancer Survivorship Program at Stanford. Schapira specializes in breast cancer with a focus on the psychosocial aspects of cancer care and issues that relate to patient experience and health equity. She recently participated in a poster discussion in the Symptoms and Survivorship track at the 2022 ASCO Annual meeting.

Schapira discusses recent innovation in addressing later toxicities in survivorship care. She highlights the importance of baseline measurements and health equity considerations in clinical practice and underscores the potential effect evolving technologies may have on the treatment landscape.

“The idea that we can [provide] certain interventions that help people with cognitive reframing and psychoeducation—delivered in their own time, without the need of a specialist—[is] very powerful,” Schapira said. “If we add up all the possible physical, psychological, emotional toxicities of cancer treatments, we come up with a large burden, not to even mention the financial hardship that many of the patients endure as well.”

View Details

For this episode of The Vitals, Oncology Nursing News® spoke with Sri Kota, MSN, BA, RN, OCN, a nurse clinician with the Rutgers Cancer Institute of New Jersey, about important updates in the breast cancer treatment paradigm for nurses to consider.

The increasing availability of options for patients with metastatic disease is exciting, said Kota, with promising drugs such as fam-trastuzumab deruxtecan-nxki (Enhertu) and sacituzumab govitecan-hziy (Trodelvy) continuing to make waves in the field. 

“[There] is something to look forward to,” she said. “The pipeline looks great.”

View Details

In this episode of The Vitals, Donna Herrera Bell, MSN, APRN, FNP-C, highlights how nurses can eliminate barriers to fertility discussions among adolescent and young adult patients with cancer.

Bell spent 14 years working with children and adolescents with leukemia and lymphoma as well as helped develop a Pediatric Onco-Fertility consult service with MD Anderson. She recently presented at the 47th Annual Oncology Nursing Society Congress about eliminating barriers to conversations around fertility preservation for adolescent or young adult patients with cancer. In our discussion, Bell highlights common barriers that young men and women face, reasons why oncology nurses may not always feel comfortable addressing the topic of fertility, and why initiating the conversation and raising fertility risk awareness is crucial following a cancer diagnosis.

“Fertility preservation is not something that everyone can do. But it is something that every [patient should] discuss, and feel empowered about,” Bell says.

For more updates in oncology, be sure to visit www.OncNursingNews.com and sign up for our e-newsletters.

If you liked today’s episode of The Vitals, please consider subscribing to our podcast on Apple Podcasts, Spotify, Google Podcasts, Amazon Music, and many of your other favorite podcast platforms, to get a notification every time a new episode is posted. While you are there, please take a moment to rate us!

Thanks again for listening to The Vitals. Be sure to never miss a beat with Oncology Nursing News®.

View Details

Loyda E. Braithwaite, MSN, RN, AGPCNP-BC, AOCNP, an oncology nurse practitioner at the University of Wisconsin Carbone Cancer Center, provides an overview of the evolving treatment landscape in hormone receptor–positive breast cancer. Braithwaite highlights the emerging role of selective estrogen receptor degraders, selective estrogen receptor modulators, and updates on aromatase inhibitors within the space. She also discusses the management of potential treatment-emergent toxicities and how recently approved agents might make active treatment more accessible for certain patient populations.

“Decision-making doesn’t happen spontaneously,” Braithwaite says. “[There] are strong data and scientific research that show new therapies are emerging. It is up to us, as advanced providers, or as nurses, to make sure that we provide that education and that support [to our patients], because the evidence is out there.”

For more updates in oncology, be sure to visit www.OncNursingNews.com and sign up for our e-newsletters.

If you liked today’s episode of The Vitals, please consider subscribing to our podcast on Apple Podcasts, Spotify, Google Podcasts, Amazon Music, and many of your other favorite podcast platforms, to get a notification every time a new episode is posted. While you are there, please take a moment to rate us!

Thanks again for listening to The Vitals. Be sure to never miss a beat with Oncology Nursing News®.

View Details

For this episode of “The Vitals,” Oncology Nursing News® spoke with Heidi Donovan, PhD, RN, professor of nursing and medicine, and co-director of the National Center on Family Support, at the University of Pittsburgh. Donovan recently co-led a study evaluating the utility of an online symptom management tool for women with recurrent ovarian cancer.

The study, which was published in the Journal of Clinical Oncology, found that women who used the intervention experienced higher satisfaction with their symptom management.

“[In my opinion] some principles of our intervention are critical and actually overdue in clinical practice for ovarian cancer and other cancers,” she noted, emphasizing the importance of systematic symptom assessment in clinical settings, and enhancing women’s confidence in their ability to manage their symptoms, as well as their confidence communicating these symptoms to their healthcare providers.

“[By systematic] I mean [asking] the same questions repeatedly, over time, in order to pick up on changes that that are affecting patients and on symptoms that are affecting their quality of life, and their ability to function on a day-to-day basis,” she said. “The second principle was really enhancing women's confidence… A lot of what we did in this intervention was try to motivate women to recognize how much [of an] effect their symptoms were [causing] and build their confidence in their ability or their knowledge of things that they could try to get better management.”

Reference

Donovan HS, Sereika SM, Wenzel LB, et al. Effects of the WRITE symptoms interventions on symptoms and quality of life among patients with recurrent ovarian cancers: an NRG Oncology/GOG Study (GOG-0259). Published online ahead of print February 7, 2022. J Clin Oncol. doi:10.1200/JCO.21.00656.

View Details

For this episode of “The Vitals,” Oncology Nursing News® spoke with Hamid Emamekhoo, MD, an assistant professor of the Division of Hematology, Medical Oncology and Palliative Care with the University of Wisconsin Carbone Cancer Center. Emamekhoo offers a snapshot of recent advances in kidney cancer treatments, an overview of caring for patients receiving immunotherapy and TKI combinations, and where future advances for kidney cancer research are headed.

“We have used high dose interleukin-2 for the treatment of kidney cancer since 1992—we have been doing immunotherapy for kidney cancer before immunotherapy was cool. But it was not the best treatment modality because it is a little hard to tolerate. It causes a lot of side effects because it mimics a severe sepsis and riles up the immune system,” explains Emamekhoo. “Of course, with the advancements in immunotherapy [and with] the approvals of [various] immune checkpoint inhibitors, that has changed significantly.”

References

1. Goodman VL, Rock EP, Dagher R, et al. Approval summary: sunitinib for the treatment of imatinib refractory or intolerant gastrointestinal stromal tumors and advanced renal cell carcinoma. Clin Cancer Res. 2007;13(5):1367-1373. doi:10.1158/1078-0432.CCR-06-2328.

2. Fyfe G, Fisher RI, Rosenberg SA, et al. Results of treatment of 255 patients with metastatic renal cell carcinoma who received high-dose recombinant interleukin-2 therapy. J Clin Oncol. 1995;13:688-696. doi:10.1200/JCO.1995.13.3.688.

3. Tung I, Sahu A. Immune checkpoint inhibitor in first-line treatment of metastatic renal cell carcinoma: a review of current evidence and future directions. Front Oncol. 2021(11):707214. doi:10.3389/fonc.2021.707214.

4. FDA approves nivolumab plus ipilimumab combination for intermediate or poor-risk advanced renal cell carcinoma. FDA. News release. April 16, 2018. Accessed March 23, 2022. https://bit.ly/37Wi3Uz

5. FDA approves Merck’s Keytruda (pembrolizumab) in combination with Inlyta (axitinib) as first-line treatment for patients with advanced renal cell carcinoma (RCC). Merck. April 22, 2019. Accessed April 22, 2019. https://bit.ly/2IKrjMM

6. FDA approves nivolumab plus cabozantinib for advanced renal cell carcinoma. FDA. News release. January 1, 2021. Accessed March 23, 2022. https://bit.ly/3JC3OC6

7. FDA approves KEYTRUDA (pembrolizumab) plus LENVIMA (lenvatinib) combination for first-line treatment of adult patients with advanced renal cell carcinoma (RCC). News release. Merck. August 11, 2021. Accessed March 23, 2022. https://bwnews.pr/3fXk8Rj

8. AVEO Oncology Announces U.S. FDA Approval of FOTIVDA® (tivozanib) for the Treatment of Adult Patients with Relapsed or Refractory Advanced Renal Cell Carcinoma. AVEO Oncology. News release. March 10, 2021. Accessed March 10, 2021. https://bwnews.pr/3byYtgo

9. FDA approves pembrolizumab for adjuvant treatment of renal cell carcinoma. FDA. News release. November 17, 2021. Accessed March 23, 2022. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-pembrolizumab-adjuvant-treatment-renal-cell-carcinoma

10. Choueiri TK, Escudier B, Powles T, et al. Cabozantinib versus everolimus in advanced renal-cell carcinoma. N Engl J Med. 2015;373(19):1814-1823.

11. Cella D, Choueiri TK, Hamilton M, et al. Health-related quality of life (HRQoL) in previously untreated patients with advanced renal cell carcinoma (aRCC) in CheckMate 214: five-year follow-up results. J. Clin. Oncol. 2022;40(suppl 6):307. doi:10.1200/JCO.2022.40.6_suppl.307

12. Choi WSW, Boland J, Lin J. Hypoxia-Inducible Factor-2α as a Novel Target in Renal Cell Carcinoma. J Kidney Cancer VHL. 2021;8(2):1-7. doi:10.15586/jkcvhl.v8i1.170

13. FDA approves belzutifan for cancers associated with von Hippel-Lindau disease. FDA. News release. Accessed August 13, 2021. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-belzutifan-cancers-associated-von-hippel-lindau-disease?utm_medium=email&utm_source=govdelivery

View Details

In this episode of “The Vitals,” we spoke with Caitlin Benda, MBA, MS, RD, CSO, LDN, a clinical oncology nutritionist supervisor at American Oncology Network, about dietary strategies to support patients undergoing curative cancer therapies. 

Throughout our conversation, Benda discussed how nurses can help change a patient’s approach to diet in order to combat complications brought about by nausea and appetite loss. In addition, she highlights the importance of allowing patients some autonomy in their diet, common gastrointestinal—related side effects with different cancer treatments, and the importance of nutrition screening tools in increasing necessary referrals.

“Oncology nurses, especially infusion nurses, are spending a lot of time around patients, gathering information from these patients that maybe the patient did not have time to communicate in the same amount of detail to the physician or to whoever they were seeing in the office,” notes Benda. “Using that information and sending referrals to dieticians early on in the process [is vital]. We know that malnutrition is a very significant problem among individuals going through cancer treatments, and it is much easier to prevent malnutrition than it is to treat malnutrition.”

View Details

In this episode of “The Vitals,” Oncology Nursing News® met with Matt Iwaniec, PsyD, a licensed clinical health psychologist with the stem cell transplant and CAR-T therapy program at Allegheny Health Network, to discuss fully integrated behavioral services as it relates to oncology.

In our discussion, Iwaniec highlights the mechanisms behind psychosocial treatments like cognitive behavior therapy (CBT) and acceptance and concomitance therapy (ACT), discusses recent advances in the behavioral health space, and underscores the need to normalize behavioral therapy for patients facing a cancer diagnosis.

“Psychologists and behavioral health professionals have a unique skill set that we can bring to the practice of oncology to help patients, families, clinicians, doctors, nurses, teaching assistants, nurse practitioners, etc deal with the stress of cancer—because it is not just stressful on the patient. It is stressful on the whole family, and it is stressful on the teams that are treating them, too.”

Iwaniec expresses that he believes integrated behavioral health care is the “way to go” for the future and should become a standard part of cancer care treatment. However, there still are a lot of unmet needs that need to be addressed, he says.

“There is still a big gap between availability of mental health care and the need for mental health care. It is a problem that is endemic everywherethroughout through all our systems. We are on this path to better integration of mental health care from start to finish with the patient. There are examples of places where that is happening, but often, behavioral health care is not fully integrated [although it] needs to be. The 2 biggest impediments to that are having the [proper] staff, but also getting the general patient population to acknowledge that mental health care is a part of cancer health care.”

View Details

In this episode of “The Vitals,” Oncology Nursing News® met with Mark Honor, PA-C, Department of Malignant Hematology, Moffitt Cancer Center, to discuss managing adverse events (AEs) related to cancer therapies. In our conversation, we discuss the different mechanisms of action of today’s most popular therapeutic options, and best principles for responding to adverse events in patients receiving combination or immunotherapies.

“I went to school to be a medical provider; they didn't go to school to be a patient. They're not going to walk up to me and say, ‘Mark, I think I had gastroparesis, can you prescribe me some metoclopramide?’ They're not going to do that. The thing is, we can be ignorant of the facts if we don't ask the right questions. You must ask the right questions.”

“[If you are] the triage nurse, or the primary nurse, you have to be invasive,” he added. “Once a patient tells you they're having a problem, you need to know what they ate last night, and what they have been eating recently. Because a lot of times by asking all those questions, the nurse can [actually] solve a lot of these problems.”

View Details

In this special episode of “The Vitals,” Oncology Nursing News® and CURE® Magazine met with Janice Post-White, PhD, RN, FAAN, to discuss her recently published book, “Standing at Water’s Edge.”

Post-White was an oncology nurse when her 4-year-old son, Brennan, was diagnosed with B-cell acute lymphoblastic leukemia. Throughout our discussion, she reflects on the intersections of her professional and personal life, the lessons she learned, and offers advice for those processing their own grief in the wake of cancer.

“I remember saying to one student, ‘You know, I really need to know more about pediatric oncology.’ And, that year, my son was diagnosed... I guess you have to be careful what you wish for. But what I also learned is that [although] I had a PhD in nursing, and I had a [cancer[ background, with a minor in immunology, pathobiology, I was interested in psycho-neuro-immunology, or how the mind and the body communicate. All of my research focused in that area, but none of what I did prepared me to be a cancer mom.”

“I did immune assays in the lab and I studied imagery and massage and mindfulness meditation, healing touch therapies, and everything I [thought] I knew about cancer. I thought I knew what it was. But it was when my son was diagnosed that I learned, I really don't know how to be a [caregiver]. There's a lot more than just knowing and the knowledge; it's really the emotional realm.”

View Details

For this episode of “The Vitals,” we spoke with Patricia Jakel, MN, RN, AOCN, University of California Los Angeles Health, and Elspeth Knill-Selby, a nurse practitioner in breast surgery at Yale University School of Medicine. The 2 experts discuss the rewards of mentorship—from both a providing and receiving perspective, as well as the importance of nurturing young nurses as they transition to acute care. 

“I think to be a well-rounded mentor, you have to have a good sense of self and understand yourself—and be able to articulate your feelings in a positive way.”

“I think I look at mentorship as kind of nurturing somebody along the way, and hopefully contributing to their success in what it is that they choose to do. In nursing, sometimes, and in medicine as well, people can kind of ‘eat their young’, so to speak. Therefore, I would look at it as nurturing and trying to create an environment that's not threatening—because certainly when you go in to nursing, and when you go into [an] advanced practice role, it's scary.”

View Details

For this episode of “The Vitals,” we spoke with Nikki Urban, a registered nurse and practice manager at Allegheny Health Network, about the implementation of a successful phone triage program at the oncology institution.

Urban discusses why the program came about, some of its successes, and how a phone triage program can bring value to an oncology center.

“The phone triage process is a patient-centered initiative that really has patient access in mind,” Urban explains. “The initiative has provided the opportunity for patients to call in and have their concerns addressed in a real-time fashion with an oncology-trained nurse.”

Urban added, “I know sometimes patients will call in [and say] ‘Oh, my goodness, I have a real person that I'm speaking to.’ Patients have been excited about it, and the oncology triage team is able to immediately address symptoms, assess patients, and decide if a patient needs a same-day visit or [if] they need to come into our infusion office for supportive care. They can schedule those appointments right at the point of the call.”

View Details

Cisplatin is a life-saving drug, says Bruce Carleton,PharmD, FCP, FISPE. However, although the drug has lifesaving benefits, it also causes some degree of hearing loss in about 60% of children who receive this therapy. Furthermore, about 40% of children who receive cisplatin require hearing aids for the rest of their lives as a result of treatment.

In this episode of “The Vitals,” Carleton, of the Department of Pediatrics, Division of Translational Therapeutics, at the University of British Columbia, spoke with Oncology Nursing News® about balancing the beneficial effects of cisplatin with it’s potential to cause permanent hearing loss, in children with solid tumors. He discusses a study he recently co-authored, whose findings indicate that children under the age of 5 years are at an increased risk of developing hearing loss because of this treatment, compared with children older than the age of 5, as well as comments on how genetics may one day play a role in reducing the risk of hearing loss in this patient population.

The study assessed 368 pediatric patients with cancer by conducting over 2000 audiological assessments before, during, and after receiving cisplatin treatment. Three years after starting therapy, 75% of patients aged 5 years and younger, and 48% of patients aged older than 5 years had experienced cisplatin-induced hearing loss. According to Carleton, these findings demonstrate a need for routine audiological assessments for children who receive this treatment.

“At the end of every cycle, we should [conduct] a hearing assessment, and we should follow the toxic course of this drug,” he says. “The legitimate concern among some clinicians is that if patients or parents know that their child is developing hearing loss, they're more likely to say, ‘Do we really have to give them this cisplatin?’”

View Details

For this episode of “The Vitals,” we spoke with Christopher Zorn, clinic operations administrator of Winship Cancer Institute at Emory University, and Gianna Bayci, RN, of the University of Chicago Medicine, about how to foster a safe, yet festive, holiday environment in oncology clinics and floors. 

The 2 experts discuss talking to patients about their approach to family gatherings, incorporating festive costumes into the oncology environment, and some favorite holiday memories from over the years. 

“Flexibility and adaptability are key. Gathering around the holidays can [be] stressful during [the] best of times, and for those that are going through a cancer journey and are potentially immunocompromised, that stress is heightened even more...We advise our patients: ‘Do what you feel comfortable doing, you don’t have to force yourself to do anything extra, [and] it is okay to set up appropriate boundaries.’”

View Details

For National Hospice and Palliative Care Awareness Month, Joe Contreras, MD, spoke to Oncology Nursing News® about some common misconceptions between the 2 and how oncology nurses can more effectively speak with their patients about palliative care.

View Details

“It is not a ‘one and done kind of thing.” It is very important to implement these skills throughout the community. It's a practice. It's a behavioral change.”

View Details

For this episode of “The Vitals,” we spoke with Kristin Barber, FNP-BC, AOCNP, Huntsman Cancer Institute, about understanding the MAP kinase signaling pathway and some of the ongoing trials targeting these mutations in gastrointestinal oncology. 

Barber discussed some of the ongoing phase 1 trials she is participating in and how she hopes the results of these trials could change patient outcomes following targeted treatment.

View Details

For this episode of “The Vitals,” we spoke with Martin Dietrich, MD, PhD, an assistant professor of internal medicine at the University of Central Florida, a fellow of the American College of Physicians, and a medical oncologist at Florida Cancer Specialists & Research Institute. Dietrich highlighted some recent advances and ongoing research in stage III non–small cell lung cancer (NSCLC) and discussed some of the ways immunotherapy and targeted therapy has evolved in recent years.

View Details

For this episode of “The Vitals,” we spoke with Chastity Washington, MPH, CHES, Center for Cancer Health Equity, Ohio State University, about how the COVID-19 pandemic has exacerbated preexisting disparities in cancer care. Chastity spoke to our team about the direct and indirect impacts of COVID 19 on disadvantaged communities, vaccine hesitancy amongst those communities, and more. 

View Details

For this episode of “The Vitals,” Oncology Nursing News spoke with Eloise Theisen, RN, MSN, AGPCNP-BC, current president of the American Cannabis Nurses Association (ACNA). She spoke to us about some the benefits and applications of medical cannabis for patients with cancer, some of the challenges and interesting updates in research, and how nurses can talk to their patients about its use, as well as monitor their patients for potential cannabis-related adverse events.

View Details

For this episode of “The Vitals,” we spoke with Cynthia Ingram, BS, RN, HN-BC, COHN-S, animal therapy coordinator, CTCA Chicago. She talked about how she pursued her dream to bring animal therapy to patients in her care center and how, together, her and her furry companion, Tori, touched the lives of many patients and caregivers and brought a little bit of joy to their day.

View Details

View Details

In this episode, we spoke to Chevon Rariy, MD, medical director of Endocrinology at Cancer Treatment Centers of America (CTCA) Chicago, and the Telehealth Program director for the CTCA, about the impact of COVID-19 on telehealth programs, the creation of the in-home infusion program, and what these changes will look like for the nurses caring for these patients. 

View Details

After hearing about the difficulties a transgender man faced in receiving a cancer diagnosis, Kelly S. Haviland, PhD, FNP-BC, found her calling. In this episode, Haviland, nurse research scientist and family nurse practitioner at Memorial Sloan Kettering Cancer Center, discusses how LGBTQ treatment has changed over the years, though there is still much more work to be done.    Read more: https://www.oncnursingnews.com/view/two-part-questions-can-improve-cancer-care-in-lgbtq-patients

View Details

Music can help alleviate stress and bring something familiar into an unfamiliar medical procedure.    In this episode, we spoke with Laura Schandert, AGPCNP-BC, nurse practitioner at Duke University School of Nursing, about her recent experiment in using music to calm the nerves of patients with blood cancers undergoing bone marrow procedures.

View Details

While some people face barriers to colorectal cancer screening, at-home fecal immunochemical tests (FIT) can help. For this episode, we heard from Diann Boyd, BSN, RN, OCN, a nurse navigator at the Penn Medicine Abramson Cancer Center. Boyd specializes in GI oncology and has a passion for ensuring that everyone completes the screening.    Boyd recently presented at the ONS Annual Congress about how to increase screening rates in Black and underserved communities. In doing so, the medical community has the opportunity to potentially catch cancers in earlier stages and improve patient outcomes.

View Details

It is well known that fear of recurrence is a major issue in the cancer community, but can genetic test results outlining risk impact those feelings?    For this episode of “The Vitals,” we spoke with Maurade Gormley, CPNP, RN, assistant professor and post-doctoral fellow at the NYU Rory Myers College of Nursing. Her recent research analyzed how Oncotype DX genomic test results may increase fear of recurrence in breast cancer survivors.

View Details

Provider communication is extremely important, especially when dealing with a pediatric cancer diagnosis. In this episode of “The Vitals,” Bryan A. Sisk, MD, MSCI, assistant professor of pediatric hematology and oncology at the Washington University School of Medicine discusses his recent research on communication barriers between healthcare providers and children with cancer and their families.    While some of these issues can be found in the broader cancer space, others – like how much information to give a 6-year-old versus a 16-year-old – align more with the intricacies of pediatrics. Sisk talks about this, and the improvements he hopes to see in this space in years to come.    

View Details

Clinicians, patients, and caregivers alike all reported that they want cancer to be a communal experience – meaning that they feel that they are supported in the journey. However, certain factors can lead to feelings of isolation.    In this episode of “The Vitals,” we spoke with Jody Koenig Kellas, PhD, department chair and professor, interpersonal, family, and health communication at the University of Nebraska – Lincoln. Her research looked at the communal cancer experience, and gives clinicians direct tips on how they can reframe hope for patients and caregivers.

View Details

When it comes to fighting clinician burnout and building resiliency, mindfulness matters. Loren Winters, MSN, ANP-BC, OCN, an oncology nurse practitioner at Massachusetts General Hospital (MGH) Cancer Center and yoga instructor, discusses how oncology nurses can find the mindfulness practice that works for them, and offers simple tips to be more present every day.    Read more about our conversation with Winters: https://www.oncnursingnews.com/view/mindfulness-is-beneficial-to-patients-and-providers

View Details

Younger age was associated with an increased instance of fear of cancer recurrence, while a pessimistic outlook was actually associated with a decrease, according to recent research led by Jacqueline Galica, PhD, RN, an assistant professor of nursing at Queen’s University.    In this episode of “The Vitals,” we spoke with Galica on her findings, and what role oncology nurses can play in helping survivors manage fear of recurrence.

View Details

Health care providers are facing an increasing amount of stress due to the COVID-19 pandemic, but there are certain factors that may make some people at a higher risk for distress than others. In this episode of “The Vitals,” we spoke to Fuschia Sirois, PhD, BSc, SFHEA, reader in social and health psychology at the University of Sheffield in the United Kingdom.    Sirois analyzed clinician stress not only during the COVID-19 pandemic, but during other infectious outbreaks as well. Her research noted which groups of clinicians had higher rates of poor mental health during the pandemic, as well as which factors help to build resiliency.

View Details

A recent study found that 19% of patients with cancer engaged in nonmedical opioid use. In this episode of “The Vitals,” we spoke with study author Sriram Yennu, MD, MS, FAAHPM, study author and professor in the department of palliative care and rehabilitation medicine at MD Anderson. Yennu outlined the risk factors that he and his team found for opioid misuse, as well as what nurses can do to promote safer opioid use.    The following factors were independently associated with nonmedical behavior: * Marital status * SOAPP score * Morphine equivalent daily dose * Edmonton Symptom Assessment Scale pain level

Read more: https://www.oncnursingnews.com/web-exclusives/1-in-5-patients-engage-in-nonmedical-opioid-use

View Details

As more health care providers and the general public get vaccinated against COVID-19, some people may be tempted to ease up on social distancing and mask-wearing efforts. However, people should continue to take appropriate precautions, especially if they have cancer or care for a loved one with cancer, explained Emily Beard, RN, OCN, CBCN, the program coordinator of breast cancer at Northside Cancer Institute in Atlanta, GA.    “It’s easy to want to go back to normal… it’s going to take some time before we really see the effects of this mass vaccination effort,” Beard said.   

View Details

As more health care providers and the general public get vaccinated against COVID-19, some people may be tempted to ease up on social distancing and mask-wearing efforts. However, people should continue to take appropriate precautions, especially if they have cancer or care for a loved one with cancer, explained Emily Beard, RN, OCN, CBCN, the program coordinator of breast cancer at Northside Cancer Institute in Atlanta, GA.    “It’s easy to want to go back to normal… it’s going to take some time before we really see the effects of this mass vaccination effort,” Beard said.

View Details

Oncology nurse practitioners are both competent and compassionate, and undergo rigorous academic and clinical training to earn the NP next to their name. However, many states still require them to work under the supervision of a physician.

For this episode, we spoke with Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP, president of the American Association of Nurse Practitioners, about the importance of nurse practitioners, and why current regulatory models are outdated.

View Details

The World Health Organization deemed 2020 the Year of the Nurse and the Midwife. Theresa Brown, RN, deemed it the year of the nurse’s voice.    In this episode, we spoke with Brown, a nurse and best-selling author, about her recent online petition to have a nurse on president-elect Joe Biden’s COVID-19 task force. She said that now, more than ever, it is vital for nurses to have their voices heard.   

View Details

Patients who are LGBTQ and have cancer may be more prone to cancer and other health disparities. However, oncology nurses and their colleagues can make a major impact on the care that they receive. 

For this episode, we'll hear from Matthew B. Schabath, an associate member of the Moffitt Cancer Center, about steps clinicians can take to create a more welcoming cancer care environment.

View Details

A recent study led by Bethany J. Petronio-Coia, PhD, RN, a nurse educator at the Rhode Island College School of Nursing, discovered the characteristics of “approachable” nurses caring for school-aged children who were hospitalized for cancer. From compassionate listening to syringe water fights, they shared some creative ways that nurses have managed to make their care a bit less scary.    Read more: https://www.oncnursingnews.com/web-exclusives/a-smiling-nurse-makes-all-the-difference-in-pediatric-oncology

View Details

The world of oncology is continuously changing, often making it difficult for oncology nurses – especially those who are just starting their career in the cancer setting – to keep up. So, Kellie Zeichner, RN, BSN, OCN, an oncology nurse at the Rutgers Cancer Institute of NJ, worked with an interdisciplinary team to create reference sheets containing key information about oncology drugs.    “When they were done with orientation, I didn’t want them to feel like they were alone,” Zeichner said in this interview with Oncology Nursing News.

View Details

Treatment for gynecologic cancer can negatively impact sexual health, yet many clinicians still feel uncomfortable about discussing these adverse events with their patients.    For this episode of “The Vitals,” we will hear from Christina Wilson, PhD, a doctoral student at the University of Utah. Wilson recently presented on sexual adverse events of gynecologic cancer at the 2020 ONS Bridge virtual conference. In this podcast, she gives tips on starting the conversation, and discusses some of the science that clinicians can fall back on to broach the subject.   

View Details

It is crucial that oncology nurses monitor for cardiac complications in their patients with hematologic malignancies. And when one is discovered, they must act.    In this episode of “The Vitals,” we spoke with Brenda Shelton, DNP, RN, APRN-CNS, CCRN, AOCN, a clinical nurse specialist at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. She discusses heart issues that can arise in patients with blood cancer, and what oncology nurses need to know. She gives a sneak peek of her upcoming presentation at the NCCN Virtual Annual Congress on Hematologic Malignancies and NCCN Virtual Nursing Forum, a free, online conference October 8-10.

View Details

The coronavirus disease 2019 (COVID-19) pandemic has affected nursing school at both the graduate and undergraduate level. While online classes may be convenient, a lack of in-person and hands-on training is a clear downside for those learning the trade.    In this episode of “The Vitals,” Jann Budiman, BSN, RN, BMTCN, discusses her experiences with nursing education during the pandemic. Budiman is currently an oncology nurse at UCLA, and is pursuing her MSN/NP degree in acute care adult/gerontology. While higher education looks a bit different than what she expected, Budiman is optimistic that nurses will rise to the challenge – as they always do – when it comes to remote learning.

View Details

Immunotherapy has become a mainstay in the treatment of non-small cell lung cancer, but more recently, it has moved into the small cell lung cancer space, too. In this episode of “The Vitals,” Beth Sandy, NP, a nurse practitioner at the University of Pennsylvania Abramson Cancer Center, discusses the immune-related adverse events (irAEs) that nurses need to be aware of when treating patients with these agents.    Sandy also discussed how some irAEs, such as difficulty breathing – which is more common in lung cancer than other tumor types – can be similar to coronavirus disease 2019 (COVID-19) symptoms. She offered advice on how to determine which it is in this unprecedented time in oncology nursing.

View Details

Educational costs in the United States continue to rise, and that could be leaving many nurses wondering if furthering their education is worth it. 

For this episode, we talk to Monica Mikheal, MSN, RN, a nurse at UCLA. Despite the debt, she continues to earn degrees. She'll talk about why this is important to her, as well as programs that can help nurses and other health care providers decrease their debt. 

View Details

For this episode, we'll talk to Rebecca Bank, BSN, RN, OCN, CHPN, a palliative care and advanced planning nurse at Sansum Clinic Ridley Tree Cancer Center, about how the COVID-19 pandemic is affective palliative care for patients with cancer. 

Cancer can already be an isolating time in someone's life, and with the added stress of social distancing, patients may feel even more alone. However, Bank offers nurses and other health care providers tips on providing that "personal touch" and letting patients know you care.