Oncology Nursing News: Top Stories from 2022

In 2022, various emerging topics grabbed the attention of our readers, from the feasibility of using neoadjuvant chemotherapy to make organ-sparing surgery more accessible for patients with rectal cancer, to using bioimpedance spectroscopy to proactively preventing chronic lymphedema, to the use of oral Minoxidil to treat later-stage alopecia in survivors, nurses showed an interest in innovative ways to improve the patient experience and their quality of life throughout the cancer continuum.

Our contributors highlighted new strategies to help patients visualize and conserve their energy, and addressed whether social media can help young patients with cancer connect with one another. Nurse experts provided downloadable summaries of emerging therapies approved across multiple indications for our Oncology Drug Crash Course column.

Finally, experts in the field provided perspective on whether bunephrophine can replace traditional opioids, and if off the-shield CAR T-cell therapy can improve accessibility for patients requiring this treatment option.

Thank you for reading Oncology Nursing News® in 2022. We look forward to bringing you more news in 2023.

10. Neoadjuvant Chemotherapy Makes Organ-Sparing Surgery More Accessible for Patients With Rectal Cancer

Three months of neoadjuvant chemotherapy may allow patients with early-stage rectal cancer to significantly downstage their tumors and undergo organ-preserving surgery without the toxicities associated with preoperative chemoradiation, according to findings from the NEO trial (NCT03259035) published in the Journal of Clinical Oncology.

“Three months of induction chemotherapy with mFOLFOX6/CAPOX may successfully downstage a significant proportion of patients with favorable-risk, early-stage rectal cancer, allowing well-tolerated organ-preserving surgical therapy with minimal effect on organ function,” wrote Hagen F. Kennecke, MD, medical oncologist with the Providence Cancer Institute and Earle A. Chiles Research Institute, and coinvestigators. “The approach offers a much-desired organ-sparing option and warrants further investigation.”

9. Opinion: Understanding Spoon Theory Is Essential for Oncology Nurses

In this contributor piece, Debi Fischer, MSW, BSN, BA, LCSW, RN, discusses “spoon theory,” which helps patients with chronic illness visualize, and therefore better conserve, their energy. She argues that this tactic can be useful for patients with cancer as well, and that oncology nurses should be familiar with the theory.

“Both spoon theory and the related fork theory are key concepts that surgical oncology nurses and licensed clinical social workers can add to their arsenal of weapons,” writes Fischer. “Understanding these concepts is helping, not only when working with this patient population, but in assessing one’s own levels of energy.”

8. Pembrolizumab Plus Bevacizumab and Cyclophosphamide Shows Promising Efficacy, Tolerability in Recurrent Ovarian Cancer

Real-world data from a retrospective study showed that pembrolizumab (Keytruda) combined with the anti-VEGF agent bevacizumab (Avastin) plus oral metronomic cyclophosphamide displayed minimal toxicity with long-term clinical responses in a significant number of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. Data were presented in a poster at the ESMO Congress 2022.

The median overall survival (OS) was 14 months (95% CI, 11-not reached) with a 6-month OS rate of 93.7% and a 12-month rate of 65%. The objective response rate (ORR) was 42%, including 3 patients with a complete response (CR). Slightly less than half (49%) of patients achieved stable disease and the total clinical benefit rate was 91%. The median progression-free survival (PFS) was 7.8 months (95% CI, 4.5-10.3) and the 6-month and 12-month PFS rates of were 61.1% and 24.5%, respectively.

7. Experts Make the Case for Buprenorphine Use in Cancer-Related Pain Management

Buprenorphine may be an effective pain management strategy for various populations of patients with cancer, according to palliative care experts Mary Lynn McPherson, PharmD, BCPS, FAAHPM; and Amy A. Case, MD, FAAHPM. The agent’s unique pharmacology, and clinical utility and safety data, make it a preferable choice over traditionally used opioids.

McPherson, who is a professor at the University of Maryland, Baltimore, and executive director of the Advanced Post-Graduate Education in Palliative Care, Graduate Studies in Palliative Care, and Online Graduate Studies in Palliative Care programs, and Case, who is the chair of Supportive and Palliative Care at Roswell Park Comprehensive Cancer Center, recently participated in an invited speaker session titled “Why Consider Buprenorphine for Cancer-Related Pain?” at the 2022 Supportive Care in Cancer Annual Meeting.

6. Oncology Drug Crash Course: Fam-Trastuzumab Deruxtecan-Nxki (Enhertu)

Alyssa Hall, FNP-BC, AOCNP, Donna Thomas, BSN, RN, OCN, Kellie Zeichner, BSN, RN, OCN, provide an in-depth look at trastuzumab deruxtecan, including the approved indications and safety considerations, in a downloadable fact sheet.

Trastuzumab deruxtecan is a HER2-directed antibody and topoisomerase inhibitor conjugate composed of 3 components: a humanized anti-HER2 IgG1 monoclonal antibody, a topoisomerase inhibitor, and a tetrapeptide-based cleaver. After it binds to HER2 on the tumor cells, trastuzumab deruxtecan undergoes internalization and intracellular linker cleavage by lysosomal enzymes. Once released, the membrane-permeable deruxtecan causes DNA damage and apoptotic cell death.

After demonstrating significant efficacy as a third-line treatment for patients with metastatic HER2-positive breast cancer, trastuzumab deruxtecan has gained approval from the FDA for 5 indications and is under investigation across solid tumors.

For a downloadable version that you can print at home, check out our oncology drug crash course page or download here:

5. The Future of CAR T-Cell Therapy: Will Off-the-Shelf Options Soon Enter the Playing Field?

In this feature piece, Ellen Tichich, MFA, MSN, RN-BC talks with Brittney Baer, BSN, RN, a patient nurse care coordinator for patients undergoing immune effector cell therapies, at Vanderbilt University Medical Center in Nashville, Tennessee; and Kelly Garvin, BSN, RN, OCN, a lymphoma specialist and primary nurse for Bijal Shah, MD, in the Department of Malignant Hematology, Moffitt Cancer Center in Tampa, Florida, about the trajectory of CAR T-cell therapy and what off-the-shelf CAR T-cell therapy options could represent for patients. According to these nurse experts, off-the-shelf CAR T-Cell therapy options could provide greater accessibility and benefit to patients.

4. Normalize Palliative Care as Part of the Oncology Treatment Plan

Patients with cancer benefit from basic and advanced palliative care services and the American Society of Clinical Oncology has recommended that palliative care be considered an essential element of cancer treatment; however, helping patients gain access to these services still represent a barrier to care.

In this piece, Marjorie Leslie, DNP, ACNP-BC, AOCNP, discusses an initiative based out of the Allegheny Health Network to connect more patients to palliative care services.

According to Leslie, this project has helped normalize the concept that palliative services as a core component of the medical oncology patient care plan. Future goals will be to maintain and grow this program as well as evaluate its outcomes.

3. Bioimpedance Spectroscopy May Play a Large Role in Proactively Preventing Chronic Lymphedema

Bioimpedance spectroscopy is a more accurate method of identifying which breast cancer survivors will need compression intervention for subclinical lymphedema compared with tape measurement to prevent chronic lymphedema, according to findings from a study published in Lymphatic Research and Biology. Moreover, the technology is easy to use and patient friendly, according to principal investigator Sheila H. Ridner, PhD, RN, FAAN.

“It is as easy to use as putting someone on a scale and getting their weight,” Ridner, research professor at Vanderbilt University School of Nursing in Nashville, Tennessee, explained in an interview with Oncology Nursing News®, noting that the underlying technology is based on electrical currents that measure the fluid between the cells. “It’s very simple [and] very quick.”

2. How Social Media Helps AYA Patients With Cancer Find Support

Compared with young children or older adults, a cancer diagnosis for adolescents or young adults (AYA) is less common. However, this means that AYA patients often feel alone or social isolated when they look around their treatment center or local patient support group.

In this contributor piece, Marlee Kiel, LCSW, a social worker with Cancer Care, discusses how social media can be a useful tool to help AYA patients with cancer connect to others in their age group.

“In the past decade, there has been a significant rise in the use of social media. Apps [such as] Facebook, Instagram, and TikTok, have continued to garner attention over the years, but over the course of pandemic, these platforms became even more important,” Kiel writes. “Many individuals turned to these platforms to stay connected when they could not physically see family and friends. Social media apps proved to be a place of community for many— particularly for AYA patients navigating a cancer diagnosis.”

1. Oral Minoxidil Demonstrates Efficacy in Treating Later Stage Alopecia in Cancer Survivors

Cancer survivors who experience both frontal and occipital late alopecia following cytotoxic or endocrine therapy may derive clinical benefit with oral minoxidil, according to data from a study at Memorial Sloan Kettering Cancer Center (MSK), which were presented during the 2022 ASCO Annual Meeting.

“Treating late toxicities [is] the bread and butter of survivorship,” Lidia Schapira, MD, FASCO, Professor of Oncology at Stanford University with a specialization in survivorship, said in a discussion of the poster. “Patients are often left to manage these by themselves. The idea of helping patients understand, self-manage, and become better at handling toxicities, [starting] from the first day in the hospital, is a very important concept.”