What Oncology Nurses Need to Know About Pharmacogenomics
A subset of precision medicine, pharmacogenomics, is also growing exponentially, especially in oncology. Currently, 165 drugs or combinations are influenced by pharmacogenetics, and 58 of those are specific to oncology/hematology.
NCI Updates Cancer Trends Progress Report
The National Cancer Institute (NCI) has proactively shared new information and trends with the general public. Through its Cancer Trends Progress Report, NCI provides descriptions of research and data to help review past experiences and assist the agency in planning for future research funding.
Get an Overview of Radiation Therapy for Cancer
Radiation therapy is a precise cancer treatment that targets tumor cells specifically and spares healthy surrounding tissues. Contrary to pharmacologic treatment methodologies, side effects are predominantly site-specific.
FDA Approves Abemaciclib As Initial Therapy for HR-Positive, HER2-Negative Metastatic Breast Cancer
On February 26, 2018, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio™) in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 HER2-negative advanced or metastatic breast cancer.
FDA Approves Durvalumab After Chemoradiation for Unresectable Stage III NSCLC
On February 16, 2018, the U.S. Food and Drug Administration (FDA) approved durvalumab (Imfinzi) for patients with unresectable stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy.
FDA Approves Apalutamide for Non-metastatic Castration-Resistant Prostate Cancer
On February 14, 2018, the U.S. Food and Drug Administration (FDA) approved apalutamide (Erleada) for patients with non-metastatic castration-resistant prostate cancer.
FDA Clears Genomic Profiling Tests for Cancer Treatment
Former National Institutes of Health (NIH) Director, Harold Varmus, when asked about cancer treatment, once said, “One of the major advances we’ve had as a result of cancer research is deep recognition of the complexity of cancer. It’s not one disease, it’s lots of different diseases. Every single cancer is different when you look at it on a genetic level.”
FDA Approves Lutetium Lu 177 Dotatate for Treatment of GEP-NETS
On January 26, 2018, the U.S. Food and Drug Administration (FDA) approved lutetium Lu 177 dotatate a radiolabeled somatostatin analog, for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults.
Immunotherapy Without Immune Cells May Be on the Horizon
Researchers have generated immunotherapy in the laboratory using nonimmune cells. If the findings can be translated into treatment, it may reduce some of the immune-related adverse events that patients experience with today’s cancer immunotherapy treatments. The study was reported in Nature Chemical Biology.
FDA Approves First Biosimilar for Cancer Treatment, Among Other New Immunotherapy Dosing and Indications
Cancer treatment options continue to multiply as 2017 concludes, with the U.S. Food and Drug Administration (FDA) granting additional new drug approvals and broadening indications for others. Checkpoint inhibitors continue to explode on the scene with accelerated approvals for various indications. Treatment options for hematologic cancers are multiplying. Additionally, the first biosimilar for cancer treatment, bevacizumab-awwb, was approved as a biosimilar to bevacizumab.
Discovery of Peripheral Neuropathy Cause May Lead to Preventive Treatments
Researchers have found that taxane chemotherapies such as paclitaxel impede a protein called Bclw, which leads to the side effect of peripheral neuropathy. The study results were published in Neuron.
FDA Grants Accelerated Approval to Bosutinib for Treatment of Newly-Diagnosed PH+ CML
On December 19, 2017, the U.S. Food and Drug Administration granted accelerated approval to bosutinib for treatment of patients with newly-diagnosed chronic phase Philadelphia chromosome positive chronic myelogenous leukemia.
FDA Grants Regular Approval to Cabometyx for First-Line Treatment of Advanced Renal Cell Carcinoma
On December 19, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to cabozantinib for treatment of patients with advanced renal cell carcinoma (RCC).
Aggressive Treatment Needed for Locoregional Recurrence in Patients With Breast Cancer
Researchers from Memorial Sloan Kettering Cancer Center in New York, NY, suggested that for women with locoregional recurrence (LRR) of breast cancer, contralateral axillary metastases should be treated aggressively for cure after excluding distant metastases. Challenges of and best practices for managing LRR was discussed at an education session during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
NCI Advancements Are Pushing Research Forward for Patients
Former U.S. Senator Arlen Specter (R-PA) put partisanship aside to support federal funding for biomedical research. And, while battling cancer himself, he spoke about the National Institutes of Health (NIH) and its crucial role in finding treatments and cures. “Health is our nation’s number one asset. Without your health, you can’t do anything. I believe medical research should be pursued with all possible haste to cure the diseases and maladies affecting Americans. I have said many times that the NIH is the crown jewel of the federal government—perhaps the only jewel of the federal government.”
FDA Approves Ogivri as a Biosimilar to Herceptin
On December 1, 2017, the U.S. Food and Drug Administration approved Ogivri (trastuzumab-dkst) as a biosimilar to Herceptin (trastuzumab) for the treatment of patients with HER2-overexpressing breast or metastatic stomach cancer (gastric or gastroesophageal junction adenocarcinoma).
FDA Approves Sunitinib Malate for Adjuvant Treatment of Renal Cell Carcinoma
On November 16, 2017, the U.S. Food and Drug Administration (FDA) approved sunitinib malate (Sutent, Pfizer Inc.) for the adjuvant treatment of adult patients at high risk of recurrent renal cell carcinoma following nephrectomy.
New Imaging Better Shows Immunotherapy Results in Brain Cancer
Researchers have developed a new approach for brain imaging that can better distinguish immune responses from tumor growth in people with glioblastoma. The findings were published in Proceedings of the National Academy of Sciences.
What Oncology Nurses Need to Know About Subcutaneous Rituxan Hycela
In June 2017, the U.S. Food and Drug Administration (FDA) approved Rituxan Hycela, a combination of rituximab and hyaluronidase, for subcutaneous administration in the treatment of follicular lymphoma and diffuse large B-cell lymphoma as well as chronic lymphocytic leukemia (CLL). This agent affords the same clinical benefit as IV rituximab, but in much less time. With this approval comes many questions about which patients are appropriate and administration considerations for subcutaneous rituximab and hyaluronidase.
FDA Update on Nerlynx™ (Neratinib) Tablets
On July 17, 2017, the U.S. Food and Drug Administration (FDA) approved Nerlynx™ (neratinib) tablets, an oral kinase inhibitor, for the extended adjuvant treatment of adult patients with early-stage human epidermal growth factor receptor 2-positive (HER2+) breast cancer, following adjuvant trastuzumab-based therapy.
FDA Approves Axicabtagene Ciloleucel for Large B-cell Lymphoma
On October 18, 2017, the Food and Drug Administration (FDA) granted regular approval to axicabtagene ciloleucel (Yescarta™) for the treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, primary mediastinal large B-cell lymphoma, high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma.
Women Respond Better to Esophageal Cancer Treatment
Women with locally advanced esophageal cancer that is treated with chemotherapy and radiation therapy before surgery are more likely to have a favorable response to their cancer treatment and less likely to have recurrence than men are, according to the results of a study published in Annals of Thoracic Surgery.
FDA Simplifies IRB Requirements for Individual Patient Expanded Access
On October 3, 2017, the U.S. Food and Drug Administration (FDA) announced updates to three final guidance documents, including Form FDA 3926 and its instructions, to simplify Institutional Review Board (IRB) review requirements for physicians seeking to treat an individual patient with an investigational drug under expanded access. The updates allow for a waiver of the requirement for review and approval at a convened IRB meeting if the physician instead obtains concurrence by the IRB chairperson (or a designated IRB member) before treatment use begins.
Recent Drug Approvals Offer New Options for Non-Small Cell Lung Cancer, Genitourinary Cancers, and More
Cancer treatment options continue to multiply as 2017 continues, with the U.S. Food and Drug Administration (FDA) granting multiple new drug approvals and broadening indications for others. Oncology clinicians and nurses are challenged with staying abreast of treatment option expansions and navigating the dynamic field of cancer treatment to effectively navigate their patients through the treatment trajectory, educating on vital points relative to treatment, minimizing morbidity and mortality, and optimizing quality of life. Following is an overview of the latest approvals for the second quarter of 2017.
FDA Grants Accelerated Approval to Nivolumab for HCC
On September 22, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab for the treatment of hepatocellular carcinoma (HCC) in patients who have been previously treated with sorafenib.
FDA Approves Lower Dose of Cabazitaxel for Prostate Cancer
On September 14, 2017, the U.S. Food and Drug Administration (FDA) approved a lower dose of cabazitaxel (20 mg/m2 every 3 weeks) in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer previously treated with a docetaxel-containing treatment regimen. Cabazitaxel (25 mg/m2 every 3 weeks) was approved for this indication in 2010.
FDA Grants Accelerated Approval to Copanlisib for Relapsed Follicular Lymphoma
On September 14, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to copanlisib for the treatment of adult patients with relapsed follicular lymphoma who have received at least two prior systemic therapies.
FDA Approves First Biosimilar for Cancer Treatment
On September 14, 2017, the U.S. Food and Drug Administration (FDA) approved Mvasi (bevacizumab-awwb, Amgen Inc.) as a biosimilar to Avastin (bevacizumab, Genentech Inc.). Mvasi is the first biosimilar approved in the U.S. for the treatment of cancer.
Manage Adverse Events From Immunotherapy and Targeted Therapy for Melanoma
New targeted and immunotherapy drug approvals have offered improved survival and disease outcomes for patients with melanoma, but the new therapies are also associated with a range of adverse events (AEs) that differ from those associated with chemotherapy. Oncology nurses will need to shift their thinking to best manage those AEs.
Oncology Nurses Drive Change In Cancer Care With Clinical Trials
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.
FDA Approves Gemtuzumab Ozogamicin for CD33-Positive AML
On September 1, 2017, the U.S. Food and Drug Administration (FDA) approved gemtuzumab ozogamicin (Mylotarg, Pfizer Inc.) for the treatment of newly-diagnosed CD33-positive acute myeloid leukemia (AML) in adults and for treatment of relapsed or refractory CD33-positive AML in adults and in pediatric patients 2 years and older. Gemtuzumab ozogamicin may be used in combination with daunorubicin and cytarabine for adults with newly-diagnosed AML, or as a stand-alone treatment for certain adult and pediatric patients.
FDA Halts Two Clinical Trials Evaluating Pembrolizumab in Patients With Multiple Myeloma
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.
FDA Approves Tisagenlecleucel for B-cell ALL, Tocilizumab for Cytokine Release Syndrome
On August 30, 2017, the U.S. Food and Drug Administration granted regular approval to tisagenlecleucel for the treatment of patients up to age 25 years with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or later relapse.
FDA Approves Olaparib Tablets for Maintenance Treatment in Ovarian Cancer
On August 17, 2017, the U.S. Food and Drug Administration granted regular approval to olaparib tablets for the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in a complete or partial response to platinum-based chemotherapy.
Are Your Patients Taking Herbs That May Interact With Their Cancer Drugs?
Many Americans use dietary supplements, including herbal products, in the belief that they are natural and safe. Patients with cancer use them often to enhance the effects or to reduce the adverse reactions of cancer treatments. However, few herbs have been thoroughly studied in humans. Therefore, their interactions with prescription drugs and the clinical relevance, remain undetermined. These interactions could be pharmacokinetic in nature when an herb alters the absorption, metabolism, or excretion of other drugs, or pharmacodynamic in which it affects the mechanism of action of other drugs when consumed together. Following are a few relevant herb-drug interactions encountered in the oncology setting.
Ethnic Minority Patients May Receive Inferior End-of-Life Care
According to the results of a study published in the Journal of Clinical Oncology, African American and Hispanic patients with ovarian cancer who lived in Texas were more likely to receive invasive or toxic treatment and be admitted to intensive care in their final month of life than their Caucasian counterparts.
Senate Passes Bill to Focus on Childhood Cancer Treatments
A new bill passed in the U.S. Senate last week will provide measures to ensure that drug companies are developing treatments for children with cancer. The RACE for Children Act is part of the U.S. Food and Drug Administration (FDA) Reauthorization Act of 2017, which aims to speed up the approval process for new treatments and medical devices and is expected to be signed into law by President Trump.
FDA Approves Liposome-Encapsulated Combination of Daunorubicin-Cytarabine for Patients With AML
On August 3, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos™, Jazz Pharmaceuticals, Inc.) for the treatment of adults with newly-diagnosed therapy-related AML (t-AML) or AML with myelodysplasia-related changes (AML-MRC), two types of AML having a poor prognosis.
Safely Provide Outpatient Care to Patients Receiving Hematopoietic Stem Cell Transplantations
High-dose chemotherapy with hematopoietic stem cell support is a well-established treatment for many hematologic malignancies. This treatment can be a difficult journey for patients and families. Historically, patients have been treated in a traditional hospital setting in anticipation of severe side effects, including mucositis, febrile neutropenia, thrombocytopenia, and pulmonary, renal, and hepatic complications. Patients can remain profoundly immunosuppressed for months while recovering from transplant. However, better supportive care in recent years has allowed many centers to move all or a portion of their transplant care into an outpatient setting.
FDA Expands Ibrutinib Indications to Chronic GVHD
On August 2, 2017, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica®, Pharmacyclics LLC) for the treatment of adult patients with chronic graft versus host disease (cGVHD) after failure of one or more lines of systemic therapy. This is the first FDA-approved therapy for the treatment of cGVHD.
FDA Grants Nivolumab Accelerated Approval for Colorectal Cancer
On July 31, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to nivolumab for the treatment of patients 12 years and older with mismatch repair deficient and microsatellite instability high metastatic colorectal cancer that has progressed following treatment with a fluoropyrimidine, oxaliplatin, and irinotecan.
Managing VTE in Patients With Cancer
Venous thromboembolism (VTE) is a potentially life-threatening event characterized by clots that form in the veins, and it is the second-leading cause of death for patients diagnosed with cancer. VTE affects up to 10% of the cancer population, making it essential for oncology providers to understand the associated risk factors and preventative measures. In addition, prompt recognition and treatment for VTE becomes crucial to patient care.
Management of Immunotherapy-Related Endocrinopathies
Advanced practice oncology nurses know how complex the care of patients with cancer can be. Every day seems to bring further advancements in the treatment and management of cancer. It can be difficult to keep up with the onslaught of new information, but our patients rely on us to bring them the latest, greatest, and safest treatment options available.
Using Standards Balances Technology Advancements With Critical Thinking
Advancements in medical records technology provide safeguards and contribute to overall patient safety. However, consider the following treatment scenarios and how they may present opportunities for error and jeopardize patient safety.
The Case of the Immunotherapy Inquiry, Part II
You may remember Jay, a 62-year-old man with inoperable stage IIIA non-small cell lung cancer (NSCLC), from the case study in the April 2017 issue of ONS Voice. He was symptomatic with a persistent cough, unintentional weight loss, and fatigue.
Massage Has Therapeutic Value for Patients With Cancer
An ancient form of bodywork that encompasses hands-on manipulation of muscles and soft tissues, massage increases circulation, reduces muscular tension and promotes relaxation. It also produces emotional and psychological benefits.
Genomic Information Helps Guide Successful Therapies for Each Patient
The healthcare landscape is changing more rapidly than ever, and daily discoveries in genomics are leading to truly individualized care. During a session at the 42nd Annual Congress in Denver, CO, David Solit, MD, Geoffrey Beene Chair and director of the Marie-Josée and Henry R. Kravis Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC), reviewed cutting-edge genomics science, its role in precision medicine, and innovative genomics programs at his institution. Solit leads a research program that seeks to identify new drug targets using genomic profiling.