Staying Informed on Genetic Targets, Adverse Events of NSCLC Treatments

As more targeted therapies become available for the treatment of non-small cell lung cancer (NSCLC), it is important for oncology nurses and advanced practice providers to continue educating themselves on these genetic mutations and common adverse events.

At the 8th Annual School of Nursing Oncology (SONO), Beth Sandy, MSN, CRNP, FAPO, nurse practitioner in the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, presented on targeted therapies in NSCLC including EGFR, ALK, ROS1, RET, and BRAF. She also spoke with Oncology Nursing News to urge all nurses and advanced practice providers to stay informed on these targets — and those that may be discovered in the future — while caring for patients with NSCLC.

Transcript:

It's super hard, and in lung cancer, I mean, thank goodness for me, it's all I do. So, you know, I do see these mutations fairly commonly in clinic, and I can stay on top of things.

I mean, education is really key here. And I'm not expecting, you know, a general oncology nurse practitioner, [physician assistant], or oncology nurse to remember every single toxicity that I'm telling you. But hopefully, you know, this is something where, if you're doing some education and you're learning at a conference, you might say, “Oh, yeah, that's right. I think it causes, you know, high blood pressure.” And then you may want to go to the package insert or to some of the, you know, educational materials for staff or patients, and sort of take a look at it and say, “Oh, yeah, that's right. Like, this is the rate of hypertension or the rate of edema with this, you know.” And then maybe go back to your notes, or go back to those slides and say, “This is how Beth said she manages it in her clinic, or how she can't manage it but often may dose reduce.”

I think that education component is just really key here. But don't feel bad. I mean, I go to the package insert. I go to our clinical pharmacist all the time and say, “Hey, what's the next dose reduction for this? Should I dose reduce now?” You know, it's hard. There's a lot of them out there, and this is where oncology is headed, which is great. It should be personalized like this, so it's great, but it's a lot for us to learn and remember.

Obviously, using things like the NCCN guidelines is going to be really helpful, too, for you to go to and plug in that, you know, mutation, and then you can see what the recommendations are for treatment.