A new cross-government program is underway to improve veterans’ access to clinical cancer trials. Together with the National Cancer Institute (NCI), the Department of Veterans Affairs (VA) Interagency Group to Accelerate Trials Enrollment launched in 12 VA facilities in summer 2018.

The Common Terminology Criteria for Adverse Events (CTCAE) is a list of adverse event (AE) terms most often encountered in oncology. It’s been in ongoing development since the 1980s and was previously referred to as the Common Toxicity Criteria. Through continual development and support from the National Cancer Institute’s Cancer Therapy Evaluation Program, CTCAE aids in the documentation and analysis of adverse events in oncology-related clinical trials.  

One of your patients is enrolled in a clinical trial and is scheduled to receive an investigational drug today. She reports a cracked tooth and asks if it’s okay to get dental work. What should you tell her? 

A. To Set up an appointment with her dentist between treatment cycles. 

B. To check with her research team before setting up a dental appointment. 

C. Not to have any dental work done since she’s on a clinical trial.  

D. Have her tooth fixed right away and let the research team know if you have any problems. 

Nurses can do it all. After all, the often-unsung heroes of health care use their unique skills to positively impact patients and their families in more ways than most people can ever imagine. Unfortunately, role confusion and a lack of awareness of a vital specialty have led to a dire need of nurses in clinical trials.

Oncology nurses know the challenges of patient adherence to oral cancer therapies. Every dose a patient misses can affect their outcomes and chance of survival. But in clinical trials, oral adherence has even broader implications: when a study is evaluating the efficacy of a drug, it depends on study participants taking it exactly as the trial outlines.

Informed consent is a comprehensive process as opposed to a check mark on a list of tasks to complete prior to starting cancer therapy. The American Society of Clinical Oncology/ONS Chemotherapy Administration Safety Standards explain that informed consent provides a patient with “sufficient information about the disease diagnosis and treatment options so that the individual can make a reasonable decision about treatment on the basis of an understanding of the potential risks and anticipated benefits of the treatment.”

The January 2018 case study introduced Vince, a 55-year-old man receiving chemotherapy and radiation for recurrent bladder cancer. He suffers from chronic back pain because of spinal stenosis and has been on opioid therapy for nearly two years.

Every quadrennial presidential cycle, as the newly elected leader moves into the Oval Office, he selects a core group of advisors who are philosophically aligned and eager to make changes in the federal government’s process. However, this is often not as simple as the new administration believes.

As part of the National Cancer Moonshot Initiative and in collaboration with the Presidential Innovation Fellows, the National Cancer Institute (NCI) developed and launched a new website in 2016. It provides user-friendly access to the repository of abstracts of cancer clinical trials that NCI supported.

Clinical trials are responsible for discovering new treatments for cancer as well as the continued evolution of standards of care in clinical practice. Nationally, less than 5% of all eligible adult patients with cancer enroll in clinical trials. Additionally, it takes a drug an average of six to eight years from when it is first introduced in trials to become fully available to all patients who could benefit from it.

On August 31, 2017, based on data from two recently halted clinical trials, the U.S. Food and Drug Administration (FDA) is issuing a statement to inform the public, healthcare professionals, and oncology clinical investigators about the risks associated with the use of Keytruda (pembrolizumab) in combination with dexamethasone and an immunomodulatory agent (lenalidomide or pomalidomide) for the treatment of patients with multiple myeloma. Keytruda (pembrolizumab) is not approved for treatment of multiple myeloma.

Before any new treatment or approach is used with people in clinical trials, researchers work to understand its effects on cancer cells in the lab and in animals. Researchers design cancer clinical trials to test new ways to treat, detect, diagnose, and prevent cancer, and manage symptoms of cancer and side effects from treatment.

One of the key factors to a cancer clinical trial’s success is the ability to enroll an adequate number of patients in an appropriate timeframe. Identifying barriers to slow accrual and ways to address them can help researchers and nurse scientists make big steps in the fight against cancer in the era of the National Cancer Moonshot Initiative.