Onc Nurse on Call

In this episode of the Onc Nurse on Call podcast, we dive deep into the clinical aspects of chemotherapy safety. Join hosts Patricia Jakel, MN, RN, AOCN, Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN as they speak with MiKaela Olsen, DNP, APRN-CNS, AOCNS, FAAN; and AnnMarie Walton, PhD, MPH, RN, OCN, CHES, FAAN; about the transition from "flush and rush" to modern engineering controls likeCSTDs. Topics include USP <800> enforcement, the importance of surface wipe sampling, and protecting vulnerable staff during conception and pregnancy.

Guest: Jessica MacIntyre, DNP, MBA, APRN, NP-C, AOCNPHosts: Patricia Jakel, MN, RN, AOCN; and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCNKey Discussion Points: The APP Infrastructure: Building specialized orientation and fellowship programs for advanced practice providers (APPs) to ensure retention and clinical excellence. The Evolution of Survivorship: Shifting the definition of "survivor" to begin at the moment of diagnosis and integrating technology to standardize care. Skin Toxicity Equity: The launch of a groundbreaking image-based database with ONS and La Roche-Posay to improve outcomes for patients of color. The Next Generation: Advice for new oncology nurses on staying curious, seeking mentorship, and the vast career opportunities within the specialty.

Episode Title: Beyond Chemotherapy: Mastering the New ASCO-ONS Antineoplastic Safety Standards with MiKaela OlsenRelease Date: April 1, 2026Hosts: Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCNGuest: MiKaela M. Olsen, DNP, APRN-CNS, AOCNS®, FAANEpisode OverviewThe landscape of cancer treatment is evolving at a breakneck pace. To keep up, the Oncology Nursing Society (ONS) and the American Society of Clinical Oncology (ASCO) released a major update to their joint safety standards. In this episode of Onc Nurse on Call, hosts Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN sit down with MiKaela M. Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director for oncology at Johns Hopkins Health System and the nurse co-chair for the updated standards.MiKaela shares her inspiring journey from an unexpected start in a military pediatric oncology unit to becoming one of the nation's leading voices in hazardous drug safety. Together, they break down the critical changes in the 2024 update, why the term "chemotherapy" is officially being phased out, and how nurses can maintain rigorous safety protocols across all care settings—including the home.Key Topics Covered The Shift to "Antineoplastics": Why the traditional word "chemotherapy" is no longer inclusive of modern targeted agents, immunotherapies, and cellular therapies. Safety Across All Settings: How the new standards apply universally, whether you are administering treatment in a major hospital, an outpatient clinic, or a patient's home. The 4-Step Verification Process: A breakdown of Domain 3, detailing the independent safety checks required by both pharmacy and nursing before a drug reaches the patient. Standard 1.7 (The Metric Rule): Why locking scales into kilograms and centimeters and requiring dual-verification for new treatment plans is the new gold standard for preventing dosing errors. Focus on Equity and Caregivers: How Domain 4 introduces language addressing social determinants of health and keeping home caregivers safe.

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.This week, Jakel and Desrosiers are joined by Jamie S. Myers, PhD, RN, AOCNS, FAAN, a research associate professor at the University of Kansas School of Nursing who discusses her career of research in oncology nursing and shares insights on funding, mentorship, and groups to become involved with for nurses who may be new to or interested in research.Her primary body of research focuses on the cognitive effects of cancer and its treatment, often referred to as “chemo brain.” This interest was sparked during her doctoral studies when she heard a former intensive care nurse describe leaving clinical practice because her own cancer treatment-related cognitive changes made her feel she could no longer practice safely. For nurses interested in beginning their own research, Myers emphasizes the importance of mentorship and collaboration over attempting to work in isolation. Reflecting on her early career, she admits she was “naive” to think she could manage projects alone and advises new researchers to partner with those who are familiar with institutional approvals and stakeholder management. This collaborative approach is essential for navigating the complex processes of various approval bodies and gatekeepers within a facility.In her closing remarks, Myers encourages oncology nurses not to rule out research, even if they are well into their careers. She notes that her own transition into research occurred when she was already a “seasoned nurse.” For those ready to take the step, the field offers a way to meet clinical needs and improve the long-term well-being of patients.

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.This week, Jakel and Desrosiers are joined by Jacqueline Redeemer, RN, MN, AOCNS, a clinical nurse specialist (CNS) in solid tumor oncology at The University of California, Los Angeles, who shared her experience integrating safe handling practices into her clinic as a CNS.While observing a hepatic arterial infusion procedure in interventional radiology (IR), Redeemer noted that staff were not consistently applying oncology nursing standards. Because the IR department did not frequently administer chemotherapy, there was a misconception that the high-dose melphalan used in the procedure posed minimal risk due to the way it was perfused. Redeemer utilized her CNS training to emphasize that even a small percentage of a highly concentrated dose remaining in systemic circulation required rigorous protection. She noted that the dose being administered was nearly 10 times higher than typical intravenous levels, making the 10% residue a significant safety concern.To address these gaps, Redeemer initiated a collaborative performance improvement project involving pharmacy, environmental services, and IR leadership. A primary challenge was the introduction of closed system transfer devices (CSTDs), which were unfamiliar to the IR team.“All staff that would manage or engage with either administering or handling body excreta or anything after...they needed to be in service and receive education,” Redeemer explained, noting that the training extended to technologists, perfusionists, anesthesiologists, and physicians.“An oncology nurse needs to be at the table at all times when there are decisions about how to administer, handle, or [introduce] new drugs,” she stated. By involving specialized nursing leadership, healthcare systems can ensure that safety standards remain consistent and evidence-based, regardless of the clinical setting or the route of administration.

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.In this episode, the hosts speak with Emely Alfaro, RN, CNS, OCN, a clinical nurse specialist at University of California San Francisco Health who oversees infusion services across sites. With 2 decades of experience in solid tumor malignancies, Alfaro discusses her clinical focus on difficult IV access (DIVA), a term used in pediatric and emergency medicine that she has worked to validate within oncology.Alfaro’s research, conducted during her Doctor of Nursing practice (DNP) program, addressed a gap in the literature regarding specialized tools for assessing DIVA in cancer patients. She developed the ONC DIVA tool by modifying the established adult difficult IV access (A-DIVA) tool to include 6 cancer-specific characteristics, such as the presence of metastatic disease and limitations due to lymph node dissections. Her findings confirmed that higher DIVA scores correlate with a higher number of required insertion attempts, reinforcing the importance of early identification.“We have [post-intervention] data and we’ve seen a much bigger decrease in patients who are getting stuck more than 3 times, which was our goal,” said Alfaro.

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.This week Kelly Grosklags, LICSW, BCD, FAAGC, FT, shares advice for oncology nurses and advanced practice providers (APPs) dealing with grief at the end of patients’ lives. Grosklags, founder of Conversations With Kelly, explained that patients perceived as being in “denial” of their prognosis are often in need of someone to listen to them, or they are perceived that way as a result of a provider requiring closure of the patient.Patients who seem unable to approach conversations about the end of life may simply need a conversation about why that is the case.“Sometimes our psyche can’t take in all this information at once, so we have to compartmentalize it,” said Grosklags. “I’ve never met a patient who…looked like they were denying something that didn’t at some point acknowledge it. You have to acknowledge something to deny it.”Understanding the mindset of these patients, Grosklags said, may take stepping back and recontextualizing the patient’s experiences.“Is this part of my own agenda as a provider that I need them to be able to talk about this?” asked Grosklags. “Why am I so activated by this patient and their ‘inability’ to [acknowledge their prognosis]?”

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.This week, social worker Kelly Grosklags, LICSW, BCD, FAAGC, FT, founder of Conversations With Kelly, shared advice for dealing with difficult conversations and false hope in the care of patients with cancer.The inspiration for her work, Grosklags said, comes from losing her mother when she was 11. While her mother, in her thirties at the time, suffered from heart disease, her young age caused clinicians to approach her care with an emphasis solely on lengthening her lifespan, rather than making the most of the reality her family was faced with.“The whole goal was to keep her going, keep her going—and no one wanted to talk about the hard stuff,” Grosklags recalled.Further, some patients develop what Grosklags referred to as “good patient syndrome,” where they fear exposing their care team to the emotional burden of difficult conversations around death and try to shield them from these by acting as if they don’t need them.Grosklags stressed that hope is cyclical and can occur at any stage of a patient’s care, even at the end of life. The goal of care may not always be cure; it may evolve to become other milestones, like seeing a child graduate high school.“Part of our job as social workers, as physicians—as anybody working in oncology—is to help introduce patients to that evolution-of-hope cycle.”

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time. This week delivers the second part of an interview with ethics expert Katherine Brown-Saltzman, MA, RN, president of Ethics of Caring, the organization behind the National Nursing Ethics Conference (NNEC). Ethical concerns can grow into pressing issues, said Brown-Saltzman, when nurses don’t confront the concern early on, comparing these situations to the rapid spread of a forest fire.“By the time you are outraged, you’re in moral distress,” said Brown-Saltzman. “To bring these issues up early really helps because then you aren’t completely locked down into conflict.”In these cases, she said that the best thing a nurse can do to intervene early on is to simply ask a question.“The wisest thing that I learned along the way was instead of pointing the finger…to put a question on the table,” said Brown-Saltzman. “’I’m beginning to have these ethical concerns and wondering, are we approaching this family in the best way?...I’m wondering how we can better approach them with questions about stopping treatment.’”

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.This episode’s guest, Melinda Mayorga, RN, MSN, CNS, AGCNS-BC, OCN, a clinical nurse specialist at Norris Comprehensive Cancer Center University of Southern California in Los Angeles, discussed end of life care and those she calls “last responders.”Mayorga described an experience in which she accompanied a patient through the last 32 minutes of her life, which, if not for the nursing staff, would have otherwise been spent alone—an occurrence altogether too familiar for many nurses.Inspired by this experience, Mayorga developed a volunteer program that pairs individuals with those at the end of life to avoid patients dying alone, as well as an interdisciplinary toolkit that involved a chaplain, mental health professionals, the arts, and even environmental manager. The program provides QR codes to instantly reach prayers prepared by the chaplain along with videos on stages of grief, battery-operated candles to light, and the option to paint a rock in someone’s memory.

Onc Nurse On Call is the new podcast by Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time. This week, our hosts sit down with Lillian Rodich, PA-C, MPH, an integrative oncology physician assistant at Memorial Sloan Kettering Cancer Center Bendheim Integrative Medicine Center in New York, New York.She also touches on how to talk to patients about outside herbs and other supplements, emphasizing that being open to discussing these with patients—and finding out for patients whether there may be interactions between the herb and the patient’s treatment instead of rejecting the topic—can build trust with patients and make them feel more comfortable being transparent with providers.Particularly, Memorial Sloan Kettering’s integrative services have a website and mobile application called “About Herbs,” which serves as a database for identifying whether an herb or supplement will have interactions with a patient’s medications.Rodich explained that there are ways to make integrative medicine more accessible to patients, regardless of what their insurance they have or what their financial situation is.“Integrative medicine shouldn’t be for the privileged few," says Rodich. "It should be standard-of-care practice for all patients, no matter where they’re receiving care.” 

Welcome to Onc Nurse On Call!Are you seeking practical insights to maximize your impact while staying at the forefront of cancer care? You’ve found the right place. Onc Nurse On Call is the new podcast by Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time. This week’s episode brings more insights from Kristin Daly, MSN, ANP-BC, AOCNP, on caring for patients receiving immunotherapy who require medical attention for adverse effects (AEs) of immunotherapies, including outside of typical clinic hours.

Welcome to Onc Nurse On Call!Are you looking for practical insights for maximizing your impact while staying on the cutting edge of cancer care? You’ve found the right place. Onc Nurse On Call is the new podcast by Oncology Nursing News’, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.Today’s episode features Katherine Brown Saltzman, MA, RN, president of Ethics of Caring, the organization behind the National Nursing Ethics Conference (NNEC), who discusses ethics in nursing.

Welcome to Onc Nurse On Call!Are you looking for practical insights for maximizing your impact while staying on the cutting edge of cancer care? You’ve found the right place. Onc Nurse On Call is the new podcast by Oncology Nursing News’, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.In this week’s episode, Korie Bigbee, DNP, a nurse practitioner at City of Hope and Kaiser Permanente in Los Angeles, California, discusses survivorship planning within the scope of hematology and beyond, focusing on institutional tactics to expand survivorship programs as well as the importance of planning for patients’ futures in a world of expanding effective treatment options for patients with cancer.

Welcome to Onc Nurse On Call! Are you looking for practical insights for maximizing your impact while staying on the cutting edge of cancer care? You’ve found the right place. Onc Nurse On Call is Oncology Nursing News’s new podcast, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time. This week, Kristin Daly, MSN, ANP-BC, AOCNP, a nurse practitioner in medical oncology at WashU Medicine in St Louis, Missouri, spoke with Oncology Nursing News about cancer care in the age of immunotherapy. As a nurse practitioner with more than 20 years of experience in oncology, Daly discusses all things immunotherapy, from pan-cancer therapy to biomarker-driven treatments, highlighting strategies for educating patients on how immunotherapy works. Daly, who treats patients with head and neck cancers, touches on common types of immunotherapies, how to handle adverse effects in the outpatient setting, and care planning for patients in rural areas. She shares helpful analogies for patient education as well as what she calls the “head tilt test,” which she uses to encourage patients to contact the clinic if a new symptom catches a patient’s attention.

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 [email protected] with your feedbackJanuary  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

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

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

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 Lung cancer: screening. US Preventive Services Task Force. March 19, 2021. Accessed August 16, 2023. https://uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening 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 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 Lung nodules. American Cancer Society. Accessed August 16, 2023. https://www.cancer.org/cancer/types/lung-cancer/detection-diagnosis-staging/lung-nodules.html Lung cancer screening. Mayo Clinic. February 11, 2022. Accessed August 30, 2023. https://www.mayoclinic.org/tests-procedures/lung-cancer-screening/about/pac-20385024 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

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 VideosMetastatic CRC Nursing Webinar Podcast Terri Pollack Offers Perspective on 2023 ASCO GI Cancers Symposium Overcome Screening Barriers in CRC ReferencesChitwood 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

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/ 2. 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/ 

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. ResourceInflammatory Breast Cancer (IBC) Scoring System online toolEpisode 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 9:30Online 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 EpisodesNurse 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 ReferenceJagsi 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

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 HighlightsI live in Erie; we are a smaller city. A lot of our testing has to be done in Pittsburgh. Time stamp (TS) 5:56Transportation is a large barrier to care for older people because [oftentimes] they have stopped driving, and they may not have the transportation. TS 7:28Technology 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. TS7:37The 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 10:07Online 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

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

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

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 well the 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 10:00Oncology 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 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 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 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

In this episode of The Vitals, Oncology Nursing News® spoke with Jacki Garcia, RN, BSN, CNRN; and Kristin 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:  Manmeet Ahulwalia 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 References1.     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/noaa1492.     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

In this episode of The Vitals, Clint Koerkenmeier, MHS, BSN, RN, joins Oncology Nursing News® to discuss retention strategies at his institution.  Koerkenmeier is associate 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 [email protected] 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 7:37Oncology 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 References1.     Our magnet designation. Vanderbilt University Medical Center. Accessed June 29, 2023. https://www.vumc.org/vanderbilt-nursing/our-magnet-designation 2.     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 3.     Vanderbilt professional nursing practice program (VPNPP). Vanderbilt University Medical Center. Accessed June 29, 2023. https://www.vumc.org/vpnpp/what-is-vpnpp 

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 Reading Oncology 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 

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

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 8:37PodcastA 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 ReferenceUS 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

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-A*02:01. 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 6:37If there was a serious case of CRS, then these patients would get medications, specifically tocilizumab, to minimize the effects. TS 7:38With nurses that are able to proactively identify and know how to manage [AEs], patients can do extremely well. TS12:52Online Articles FDA Follow-Up: Utilizing Tebentafusp in Clinical Practice for Metastatic Uveal Melanoma FDA Approves Tebentafusp to Treat HLA-A*02:01 Positive Uveal Melanoma Tebentafusp Boosts Survival in Metastatic Uveal Melanoma PodcastsA 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

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 References1.     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 2.     FDA approves teclistamab-cqyv for relapsed or refractory multiple myeloma. FDA. October 25, 2022. Accessed April 10, 2023. https://bit.ly/3f3HffB3.     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

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 [email protected] 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 ManagementVideo 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 OncologyReferences1.     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.LBA4432.     FDA approves nivolumab for adjuvant treatment of urothelial carcinoma. FDA. News release. August 19, 2021. Accessed April 3, 2023. https://bit.ly/3ztbkfm 

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 

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 10:51The 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 Oncol. 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

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 [email protected] 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 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 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 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 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. 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 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 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

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 [email protected] 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.

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 [email protected] with your feedback ReferencesJanuary FDA Approves Tebentafusp to Treat HLA-A*02:01 Positive Uveal MelanomaFebruary Cilta-Cel Snags FDA Approval for Relapsed/Refractory Multiple MyelomaMarch  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 AprilAxi-Cel Snags FDA Approval for Second-Line LBCLMay 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 JulyCrizotinib 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 

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

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.

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  

For this episode of The Vitals, Oncology Nursing News® spoke with Jeannette 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 InterviewsOncology 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 

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 19:14Episode 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

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 HighlightsTop 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 NotesThe 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 PollutionVideo Interviews·      Expert Says Pandemic Put a ‘Lens’ on Health Disparities for People Outside the Medical FieldReferences 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®.

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 HighlightsTop 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 InterviewsHeather E. Wheeler Discusses Cisplatin-Induced Hearing LossReferences 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

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. 

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.”

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, Donahue 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 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 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

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.”