With more than 90% of oncology radiation practices reporting staffing shortages, patients are facing new barriers to accessing timely cancer care, the American Society for Radiation Oncology said when announcing its 2023 staffing survey results. At about half of those practices, the lack of adequate staffing is delaying treatment for patients seeking interventional or palliative radiation therapy—and reducing patient navigation services—both of which ultimately influence patient outcomes.

Biomedical breakthroughs for cancer have enhanced research and discovery at record rates, giving patients extraordinary survivorship opportunities. It is a remarkable, unprecedented time. At the vanguard of understanding is the role of biomarkers and identifying each patient’s unique cancer signature through biomarker testing. Through the testing process, patients and providers can better determine an appropriate, individualized treatment path.

Once abandoned because of dose-limiting toxicities, a novel chemotherapy drug is showing even more promise as a modified prodrug. In study results published in Science Advances, researchers demonstrated how turning DRP-104 into a prodrug enables it to kill more tumor cells and activate CD8+ T cells with a “markedly improved tolerability profile.”

Almost 22 years after the September 11, 2001, atacks, the World Trade Center Health Program has added all types of uterine cancer to its list of WTC-related health conditions. The WTC Health Program assists patients with treatment costs for uterine cancers that meet WTC-related health condition eligibility and certification requirements.

Adding carboplatin to standard neoadjuvant chemotherapy for patients with triple-negative breast cancer improves complete response, event-free survival, and overall survival, researchers reported in study findings presented in abstract GS5-01 during the 2022 San Antonio Breast Cancer Symposium. 

Overall cancer death rates continued to decline from 2015–2019 among men, women, children, adolescents, and young adults in every major racial and ethnic group, according to the October 2022 Annual Report to the Nation on the Status of Cancer. The National Cancer Institute, Centers for Disease Control and Prevention, American Cancer Society, and North American Association of Central Cancer Registries jointly issue the report each year to monitor cancer trends across society.

Clinicians and researchers know little about the mechanisms for chemotherapy-induced peripheral neuropathy, a side effect of neurotoxic agents that can cause numbness, tingling, and pain in the upper and lower extremities. Until recently, mechanism-based treatment was difficult, but biomarkers are helping nurse scientists identify a potential connection to the hypothalamic-pituitary-adrenal axis.

On October 31, 2022, the U.S. Food and Drug Administration recommended that healthcare providers discuss alternative options for magnetic resonance imaging–guided breast biopsy procedures with patients if a facility is unable to perform it because of a shortage of Philips Invivo MRI breast biopsy grid plates and other Philips Invivo MRI disposables. 

Poorer outcomes among males receiving BRAF or MEK inhibitors for melanoma may be related to an increase in androgen receptors, researchers discovered in study findings published in Nature.

On September 15, 2022, the U.S. Food and Drug Administration reported Baxter Healthcare Corporation’s recall of Clearlink basic solution set with Duovent because of reports of leaks. FDA identified it as a class I recall, the most serious type of recall, where use of the set may cause serious injuries or death.

Diarrhea is a distressing condition that significantly affects patients’ quality of life and social functioning. Characterized by passage of more than three unformed stools in 24 hours, in cancer it can be caused by chemotherapy, radiotherapy, laxatives and antibiotics, enteral feeding, malabsorption syndromes, colectomy, or several types of malignant tumors. Diarrhea has also been reported in long-term cancer survivors. Standard treatment options such as opiate agonists and adsorbents are associated with side effects that may increase a patient’s symptom burden.

An estimated 16% of patients with cancer experience depressive spectrum disorders in oncologic, hematologic, and palliative care settings, seriously affecting their quality of life. Although conventional antidepressants can be effective in many situations, they are associated with adverse effects, such as fatigue, drowsiness, sleep difficulties, nausea, weight gain, nervousness, dry mouth, blurred vision and sexual dysfunction.

More than 90% of patients report that telehealth consultations during radiotherapy treatment are high quality and may be even better for understanding information from their healthcare team than in-person visits, researchers reported in the Journal of the National Comprehensive Cancer Network.

Novobiocin, an antibiotic discovered during the 1950s, may be a potential second-line therapy for patients whose tumors have become resistant to poly (ADP-ribose) polymerase (PARP) inhibitors, researchers reported in Nature Cancer. The finding may open up new options for patients with BRCA-variant disease such as breast, ovarian, pancreatic, and prostate cancer.

Genetic counselors have a unique ability to explain complex genetic information to patients, providers, and our healthcare colleagues and to empower patients to take an active role in their healthcare decisions. We review biosignature data points and help explain the difference between variants that were acquired (somatic) versus those that may have a germline component, or possibly inherited from a parent. By working with oncology teams, genetic counselors provide guidance on potential next steps to evaluate variation occurrences and how providers, patients, and their families can use the information to guide their care.

Biomedical research is what transforms medicine. Oncology nurses see the evidence of that daily, from discoveries like immunotherapy that have revolutionized cancer treatment to novel nursing approaches to managing symptoms and adverse events. And thanks to the studies that brought a COVID-19 coronavirus vaccine to market in record-breaking time, the world understands research like never before, too.

PITTSBURGH, PA—October 12, 2021—Research shows that physical activity during cancer treatment mitigates some of the negative physical and psychosocial outcomes associated with diagnosis and treatment. Released in the October 2021 issue of the Clinical Journal of Oncology Nursing, results of a pilot study by Judi K. Forner, DNP, APRN, ACNS-BC, RN-BC, Andrea Doughty, PhD, Matthew David Dalstrom, PhD, MPH, Brandie L. Messer, DNP, RN, PCOE, and Shannon K. Lizer, PhD, APRN, FNP-BC, FAANP, demonstrated the positive impact of the Oncology Nursing Society’s (ONS’s) Get Up, Get Moving program.

Using antibiotics during treatment with immune checkpoint inhibitors may limit the therapy’s effect, according to study results published in the American Journal of Clinical Oncology.

When chimeric antigen receptor (CAR) T-cell therapies were first approved for cancer in 2017, nurses didn’t have years of clinical practice experience with the treatment to understand its full scope of nursing implications yet. Now that nearly five years have passed—and new CAR T-cell therapies have been approved, bringing the total number of treatments to five as well—oncology nurses and nurse scientists have built a robust knowledge base.

Access to treatment for opioid use disorder is a priority in the Biden-Harris administration’s healthcare program, with resources from the U.S. Department of Health and Human Services (HHS) dedicated to raise awareness of the issue. In April 2021, HHS released new practice guidelines to expand evidence-based treatment to more Americans with opioid use disorder.

To control the COVID-19 coronavirus pandemic, society needs public health measures (e.g., masks, physical distancing, hand washing), treatments for infection, and vaccines to prevent infection or serious disease. As the most trusted profession, nurses have a responsibility to educate patients and the community about the facts and science behind the vaccines. This reference sheet will help guide those conversations and is regularly updated as new information is released.

One aspect that ambulatory oncology nurses must consider in the greater staffing conversation is the time spent on educating patients and caregivers about oral chemotherapy safety in the home setting. Developing an educational framework to guide those conversations not only ensures that all critical information is covered but also that it’s delivered in a standard and efficient process. 

On March 2, 2020, the U.S. Food and Drug Administration (FDA) approved isatuximab-irfc (Sarclisa^®) in combination with pomalidomide and dexamethasone for adult patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor.

On February 25, 2020, the U.S. Food and Drug Administration (FDA) approved neratinib (Nerlyn®) in combination with capecitabine for adult patients with advanced or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2 based regimens in the metastatic setting.

Niraparib was approved in October 2019 for patients with homologous recombination deficiency (HRD)-positive advanced ovarian, fallopian tube, or primary peritoneal cancer. 

Three years ago, Sarah, age 54, completed standard chemotherapy and radiation treatment for stage II, ER- and PR-positive, HER2-negative invasive breast cancer. A recent computed tomography scan, ordered to evaluate persistent hip pain, revealed bone lesions, and a biopsy and positron-emission tomography scan confirmed bone-only metastatic breast cancer. A CDK4/6 inhibitor, ribociclib, was added to the letrozole she was already taking.

Although cancer biosimilars have been used in European countries and in U.S. supportive care for some time, biologic medications are still new to cancer treatment in the United States. With greater support coming in at the federal level and from agencies like the U.S. Food and Drug Administration (FDA) and Federal Trade Commission, the rising biosimilar tide could soon reach a new highwater mark for healthcare professionals—and nurses specifically.

Clinical trial results show that PD-1 inhibitors offer improved survival and a better safety profile compared to standard, single-agent chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck. However, because of their mechanism of action as immunotherapy, patients receiving the agents may experience immune-related adverse events (irAEs).

Pegilodecakin, an investigational, first-in-class drug currently in clinical trials, is demonstrating positive safety results and measurable responses when used in combination with pembrolizumab or nivolumab in patients with non-small cell lung cancer (NSCLC) or kidney cancer. The findings from the multicenter, phase IB study were published in Lancet Oncology.

One in nine men will be diagnosed with prostate cancer, the second leading cause of death in men in the United States. Survival varies greatly depending on the disease’s severity and extent at diagnosis: five-year survival rates are near 100% for local or regional disease, but they drop to 30% for metastatic prostate cancer.

On January 23, 2020, the U.S. Food and Drug Administration (FDA) granted accelerated approval to tazemetostat for adults and pediatric patients aged 16 years and older with metastatic or locally advanced epithelioid sarcoma not eligible for complete resection.

Entrectinib was approved by the U.S. Food and Drug Administration in August 2019 as the third tumor-agnostic cancer drug, meaning it targets a specific mutation of the cancer, not the organ of origin. The other two currently approved tumor-agnostic drugs are larotrectinib and pembrolizumab.

On January 9, 2020, the U.S. Food and Drug Administration (FDA) approved avapritinib (Ayvakit^TM) for adults with unresectable or metastatic gastrointestinal stromal tumor harboring a platelet-derived growth factor receptor alpha exon 18 mutation, including D842V mutations.

On January 8, 2020, the U.S. Food and Drug Administration (FDA) approved pembrolizumab for the treatment of patients with Bacillus Calmette-Guerin unresponsive, high-risk, non-muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.  

Oral oncolytics have introduced a different level of complexity to care. Many patients won’t ever receive their treatments in the infusion room, which is where nurses have traditionally offered in-depth patient education. Instead, nurses are using new tools—like the Oral Chemo Education Sheets—to ensure patients have the information they need to understand their treatment and its side effects.

Radium 223 dichloride (Xofigo^®) is an alpha particle-emitting radioactive therapeutic agent approved by the U.S. Food and Drug Administration in 2013 for castrate-resistant prostate cancer.

On December 20, 2019, the Food and Drug Administration granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu®) for patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting.

On December 18, 2019, the U.S. Food and Drug Administration granted accelerated approval to enfortumab vedotin-ejfv (Padcev^TM) for adult patients with locally advanced or metastatic urothelial cancer who have previously received a programmed death receptor-1 (PD-1) or programmed death-ligand 1 inhibitor, and a platinum-containing chemotherapy in the neoadjuvant/adjuvant, locally advanced or metastatic setting.

Bioengineers may have found a way to use tamoxifen activated with blue light to control precisely which tissues and body areas CAR T cells attack, reducing toxicities in other parts of the body. They reported their work in ACS Synthetic Biology.

On December 16, 2019, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi^®) for patients with metastatic castration-sensitive prostate cancer.

Already the third leading cause of cancer deaths worldwide, hepatocellular carcinoma (HCC) is a continually growing burden as the incidence of obesity, type II diabetes, and hypertension also increase, which may lead to cirrhosis and nonalcoholic fatty liver disease. Its incidence is highest in Asia and Africa, where the prevalence of hepatitis B and hepatitis C may result in chronic liver disease and subsequently HCC. 

On December 3, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq®) in combination with paclitaxel protein-bound and carboplatin for the first-line treatment of adult patients with metastatic non-squamous non-small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberrations.

Combination treatment with a CDK4/6 inhibitor and aromatase inhibitor (AI) results in similar progression-free survival (PFS) rates in women with hormone receptor-positive, HER2-negative metastatic breast cancer who are aged 70 or older compared to younger women, according to study findings published in the Journal of Clinical Oncology.

Because of the potential for leakage at the joint between the blood filters and tubing, B. Braun issued a voluntary recall of 22 lots of its y-type blood administration sets in November 2019. The recalled sets are used to deliver blood from a container to a patient's vascular system through an IV catheter inserted into a vein or central venous catheter.

Blinatumomab received accelerated approval from the U.S. Food and Drug Administration (FDA) in 2014 for the treatment of B-cell precursor acute lymphoblastic leukemia. The drug’s unique administration procedures have prompted nurses to evaluate their practice for safety.

On November 21, 2019, the U.S. Food and Drug Administration (FDA) approved acalabrutinib (Calquence®) for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).

Receiving antibiotics in the 30 days prior to starting immune checkpoint inhibitor treatment was associated with significantly reduced median overall survival, according to findings from a study published in JAMA Oncology. However, antibiotic use during treatment had no effect on survival.

Jenni is an oncology nurse practitioner in an outpatient medical oncology clinic. She is meeting with 70-year-old Don after his first cycle of cabozantinib for treatment of metastatic medullary thyroid carcinoma when he asks why the oncologist put him on a pill instead of using IV chemotherapy. “Is it because I don’t have long to live?” Don wonders.