Lindsay Fischer is the Associate Editor at ONN. She joined MJH life sciences in 2021 after graduating from Rutgers University with majors in both English and Spanish and a minor in creative writing. When she is not writing, or researching the latest oncology nursing news, Lindsay is an amateur backpacker and rollerblader. Email Lindsay at lfischer@mjhlifesciences.com

Most adult cancer survivors who undergo treatment with either a platinum-based chemotherapy, taxane alone, or a combined regimen of platinum- and taxane-based treatment, experience some degree of hearing loss, according to results from a study published in 

Among 273 survivors of breast, gastrointestinal, gynecological, or lung cancer, the rate of audiogram-confirmed hearing loss ranged from 52.3% to 71.4%. The rate of tinnitus among survivors ranged from 37.1% to 40.0%. In terms of treatment, 12.8% received a platinum-containing regimen, 56.8% a taxane-containing regimen, and 30.4% a platinum-containing and taxane-containing regimen. No differences were observed across the 3 different groups of chemotherapy-treated patients.

“It’s really very surprising because it is a group of patients [with] very common cancers: breast lung, and gynecologic malignancies,” senior and corresponding author Christine Miaskowski, PhD, RN, professor for the Department of Physiological Nursing and Anesthesia at UCSF School of Nursing, said in an interview with 

Miaskowski served as investigator in a previous trial assessing the rates of chemotherapy-induced neuropathy in cancer survivors which also asked participants to self-report hearing loss occurrence. To the investigators’ surprise, 40% of these patients reported hearing loss and 25% reported tinnitus.

“When we found this high rate of hearing loss, I went to our clinician colleagues, I went to the nurses, I went to the physicians and said: Do you ask about this? Nobody asks. So, we wrote another grant,” Miaskowski said. “Lo and behold, we found that between 50% to 70% of survivors have audio-metrically confirmed hearing loss.”

pediatric patients receiving platinum-based regimens

 In adults, hearing loss assessments have generally been limited to patients receiving aggressive platinum compounds as part of active treatment for 

Known risk factors for cisplatin-induced ototoxicity include a higher cumulative dose, younger age at exposure, concomitant radiation, being male, and the coadministration of other potentially ototoxic compounds, such as antibiotics.

 Taxane, which may be administered as monotherapy or in combination with platinum compounds, has been found to induce neurotoxic effects in the peripheral nervous system; however, its relation to ototoxicity is not well understood.

“The majority of the literature about hearing loss is related to platinum compounds, which is commonly prescribed across these common cancers,” Miaskowski noted. “What was a new finding—in terms of the drug regimens—is that there is another class of neurotoxic drugs called taxanes. It has been known for a long time that [taxanes] produce peripheral neuropathy. [But] one of the new findings from this study was that these compounds are equally likely to produce hearing loss and or tinnitus.”

Breast, gastrointestinal, gynecological, and lung cancer represent the 4 most common cancer types in the US, and platinum- or taxane-based regimens are the most common treatments for these malignancies. Therefore, when the larger study indicated that the rates of ototoxicity might be high in these areas, the investigators began to home in on this finding.

This study conducted audiometric assessments that obtained pure tone air conduction thresholds bilaterally at frequencies of between 0.25 kHz to 16.0 kHz. Each survivor’s audiogram was evaluated in hearing using the National Health and Nutrition Examination Survey–modified Occupational Safety and Health Administration standards and adjusted for age-related and gender-related changes.

According to Miaskowski and her coinvestigators, survivors should be screened for hearing loss and tinnitus on a routine basis. Further, patients who demonstrate signs of hearing loss should be assessed via audiogram to see whether they require a hearing aid.

“The good news is that the type of hearing loss these patients experience is amenable to a hearing aid,” she said. “If we can get people tested, and they demonstrate this kind of hearing loss, we can improve their quality of life.”

Moreover, according to Miaskowski, this interventional strategy does not present with many challenges.

“I don’t think there are huge problems with testing,” she said. “A physician can prescribe [it and] you go to Costco and get a hearing test. The tests are readily available. [However,] we should be doing this because [individuals] really underestimate the amount of hearing loss they’re experiencing, and it’s treatable.”

If a survivor scored poorer than the 50th percentile for their age or gender, they were classified as having experienced hearing loss. If they reported that they were conscience of tinnitus for more than 10% of their waking time, they were classified as having tinnitus. Parametric and nonparametric tests were used to evaluate differences among the chemotherapy groups.

Since manageable interventions are available, Miaskowski said that nurses can help improve quality of life by ensuring the survivors are receiving audiological assessments throughout their longitudinal care.

“We often do not think about those consequences, in terms of occupation, social gathering, etc,” she said. “But I think, as nurses, we need to be [encouraging these] assessments.”

For example, Miaskowski noted that if a patient has hearing loss, they are less likely to participate in social functions or gatherings because they may not be able to hear others. “There are consequences in terms of mood, quality of life, [and] social interaction,” she said. “I’ve gotten emails from patients [including] one nurse who contacted me and said that her hearing loss is so significant that she’s having trouble hearing blood pressures. It has [effects] on employment and function, [as well].”

Cheung S, Henderson-Sabes J, Mastick J, et al. Cancer survivors and neurotoxic chemotherapy: hearing loss and tinnitus. 

. Published online July 27, 2022. doi:10.1136/spcare-2022-003684

Romano A, Capozza MA, Mastrangelo S, et al. Assessment and management of platinum-related ototoxicity in children treated for cancer. 

2020;12(5):1266. doi:10.3390/cancers12051266

Biro K, Noszek L, Prekopp P, et al. Characteristics and risk factors of cisplatin-induced ototoxicity in testicular cancer patients detected by distortion product otoacoustic emission. 

. 2006;70(3):177-184. doi:10.1159/000093776

Cheraghi S, Nikoofar P, Fadavi P, et al. Short-term cohort study on sensorineural hearing changes in head and neck radiotherapy

2015;32(7):200. doi:10.1007/s12032-015-0646-3

Langer T, am Zehnhoff-Dinnesen A, Radtke S, Meitert J, Zolk O. Understanding platinum-induced ototoxicity. 

. 2013;34(8):458-469. doi:10.1016/j.tips.2013.05.006

Articles

Hearing loss for cancer survivors is largely underreported, but once identified, is easily treatable, according to Christine Miaskowski, PhD, RN.

Audiological Assessments May Be Vital Component of Cancer Survivorship Care Following Chemotherapy

Leslie Smith, DNP, RN, APRN-CNS, BMTCN, AOCNS

Treatments for patients with Hodgkin and non-Hodgkin lymphoma have entered a new era with the advent of targeted and personalized therapies such as bispecific T-cell engagers (BiTEs) and CAR T-cell therapies.

“The future direction for lymphoma treatment is targeting the lymphoma and the signaling pathway of the B cell,” Leslie Smith, DNP, RN, APRN-CNS, BMTCN, AOCNS, said. “Most lymphomas are B-cell [lymphomas] and that’s really drilling down into what is happening at the cellular level, how the lymphoma cell is communicating, so [we’re seeing] very targeted therapy.”

Smith, a clinical nurse specialist at the National Institutes of Health (NIH), discussed treatment selection in this patient population and how new therapies are changing the lymphoma landscape.

How has the landscape for the treatment of lymphoma changed?

 Traditionally, both Hodgkin and non-Hodgkin lymphoma have been treated with chemotherapy; Hodgkin gets chemotherapy and radiation therapy [and] non-Hodgkin is treated with chemotherapy and then monoclonal antibodies, which changed the paradigm [and improved] survival for patients with non-Hodgkin in the late 1990s.

Now, lymphoma treatments are focused on the genetic drivers of the disease and as a consequence the genetic drivers lead to the signaling pathway. [We must then ask] what are the signaling pathways of the lymphoma cell that are altering the way the immune system or the lymphomas or the lymphocyte is interacting with its environment and becoming a lymphoma cell.

If we can target those pathways, it becomes targeted therapy, as opposed to general chemotherapy or radiation therapy. These include some traditional drugs, [such as] the immunomodulatory drugs lenalidomide [Revlimid] and thalidomide [Thalomid], and the BTK inhibitors ibrutinib [Imbruvica], acalabrutinib [Calquence], [and zanubrutinib (Brukinsa)]. In addition, checkpoint inhibitors have made a huge difference in relapsed [or] refractory disease.

You can’t have a discussion about [lymphoma] without talking about CAR T cells, which even though they have shown great response rates it has not been [inducing] remission for a lot of patients.

So, there are multiple drugs—BTK inhibitors, IMids, PI3K inhibitors—that target various parts of the signaling pathway that drive the development of lymphoma and [drive the] prevention of apoptosis.

How are BiTES playing a role in lymphoma treatment? What data support their use in the clinical setting?

BiTEs, such as blinatumomab [Blincyto], are important to talk about. [They] have shown early success as far as conferring remission. Blinatumomab specifically had a lot of toxicities in the trials and many patients with lymphoma came out early because of the neurotoxicity and they had grade 3/4 cytokine release syndrome [CRS].

In addition, there was not a sustained response, so patients relapsed within a few months after receiving the drug. There are newer BiTEs now, REGN1979 also called odronextamab, and glofitamab. Those have shown better response rates with lower toxicity—patients did not have neurotoxicity…or CRS. The debate is how to dose or administer the drug. Should it be a weekly infusion on a flat dose, or should it be an escalating dose type of infusion? [Investigators are] still trying to figure that out, but [early efforts are] showing some promise with getting patients in remission.

Interestingly, these drugs are showing better response in indolent lymphomas, especially follicular lymphoma, rather than the more aggressive lymphoma. There is still more work to be done looking at these drugs, but they are showing some promise.

Could you discuss the evolving role of CAR T-cell therapy in treating patients with lymphoma? What benefits and limitations are we observing regarding this treatment approach? What are your thoughts on incorporating CAR T-cell therapy into earlier lines of treatment?

CAR T-[cell therapy] has been a great drug for relapsed [or] refractory non-Hodgkin lymphoma, as far as confirming progression-free survival. However, similar to what we’re seeing in leukemia, [the] cancer is smart, it outsmarts us all the time. It changes its antigen receptors on the surface of the malignant cell and then we have loss of antigen and so any CAR T cells that are remaining in the patient’s body that are there and go unnoticed don’t have anything to attack. Now the malignant cell has transformed itself to be able to survive.

For patients, the progression-free survival rate in lymphoma for the CD19-[targeted] CAR T cells, which is mostly what’s approved now for lymphoma, is 30% to 50% [PFS rate]. At NIH, we’re looking at CAR T cells that target 2 antigens, such as CD19 and CD20; we’re trying to target 2 antigens on the surface of the receptor itself.

There’s [the question of] should we pair CAR T cells with checkpoint inhibitors because the CAR T cells also get exhausted, like the T cells in our normal immune system and the checkpoint inhibitors may take care of that. The TRUCKs, which stands for T cells redirected towards universal cytokine killing, [are armored CAR T cells]. They confer genes to help stimulate a big cytokine response within the immune system to kill the malignancy. [Approximately] half of patients will get a sustainable recovery, but as far as being used upfront, I think that’s the same discussion that hematologists have with the leukemia population. Should we use them first, reserve them for relapsed [or] refractory, should they be a terminal treatment in that patient gets CAR T, does it need a transplant, or should it be a bridge to transplant?

CAR T has a lot of [adverse] effects. An older patient may have more difficulty because non-Hodgkin lymphoma is a disease of patients older than 60 [years], maybe in their 70s. It is also very expensive, remaining about a half a million dollars to get this treatment and I think most places still require a caregiver to be with the patient during the initial few months. That can be a challenge for some [individuals] who have children, are working, or maybe do not have family and friends who are available.

But I think CAR T is showing promise and there was a new [therapy] just approved for mantle cell lymphoma [brexucabtagene autoleucel (Tecartus)] that got early approval [which is promising because] mantle cell lymphoma is a very rare, aggressive type of lymphoma. I think there’s a lot of room for CAR T but they're still manipulating the CARs to make a more effective response.

In your opinion, has CAR T-cell therapy impacted the suitability of autologous stem cell transplantation for certain patients with lymphoma?

I think it has. Transplant is not without risk. First you must find a donor—does a patient have a family member who is a matched-related donor because a match-related doner is better if they have the human leukocyte antigen [HLA] matching.

In older patients, transplant can sometimes be fatal. There’s the sequelae of transplant years down the line where patients are still prone to infection and secondary malignancies as time goes on over the general population. Perhaps CAR T for an older patient would be a better choice than transplant, especially since we have allogeneic CAR T cells, where you can get CAR T can come from a donor, and you don’t have to worry so much about the HLA matching as much as you do with a stem cell transplant. For some patients CAR T may be a better option then a transplant.

What are some important considerations when selecting a treatment regimen for a patient with lymphoma?

What stage is the disease? Did the patient present at a stage 3 or 4 disease? What type of lymphoma do they have? Do they have a T-cell lymphoma [which] tends to be more aggressive than a B cell? What is the age of the patient? When I was in Ohio, I took care of a patient he was 90 years old, maybe 91, but he was still working full time, he was playing golf every day, he had lymphoma and he wanted everything [treatment wise]. And he could take it because chronologically he was 92 [years], but he was more like 50 [years] because he would run around in circles around the nurses. I think it depends on the age of the patient and their comorbidities status. Do they have some renal failure or liver failure, are they a diabetic?

Those are things to consider, as well as asking the patients what they want. It’s hard to separate out sometimes what the patient [wants] and what the family wants. I think the stage of the disease, their comorbidities, the age of the patient, those are considerations for what type of treatment to go for. Now that we have oral drugs for lymphoma, those are a good option for [older] patients that may not want aggressive treatment.

Leslie Smith, DNP, RN, APRN-CNS, BMTCN, AOCNS, discusses new therapies and treatment selection in the lymphoma landscape.

Smith Discusses Evolving Landscape of Lymphoma Treatments 

Kristi Rosa joined MJH Life Sciences in 2016 and has since held several positions within the company. Prior to working at the company, she served as lead copywriter and marketing coordinator at The Strand Theater. Email: krosa@onclive.com

The FDA has granted priority review status to a biologics license application for elacestrant for the treatment of patients with estrogen receptor–positive/HER2-negative advanced or metastatic breast cancer. The anticipated decision date is February 17, 2023.

The decision is supported findings from the phase 3 EMERALD trial (NCT03778931), in which treatment with the oral selective estrogen receptor degrader (n = 239) resulted in a 30% reduction in the risk of disease progression vs standard of care (SOC; n = 238) per blinded independent central review (BICR; HR, 0.70; 95% CI, 0.55-0.88; 

 The median progression-free survival (PFS) with elacestrant was 2.8 months compared with 1.9 months with SOC.

Data from a landmark analysis revealed that the 12-month PFS rates achieved with elacestrant vs SOC were 22.3% (95% CI, 15.2%-29.4%) and 9.4% (95% CI, 4.0%-14.8%), respectively.

 mutations at baseline (n = 228), elacestrant (n = 115) reduced the risk of disease progression by 45% over SOC (n = 113; HR, 0.55; 95% CI, 0.39-0.77; 

 = .0005). Specifically, the median PFS in the elacestrant and SOC arms were 3.8 months and 1.9 months, respectively. The 12-month PFS rates in the investigative and control arms were 26.8% (95% CI, 16.2%-37.4%) and 8.2% (95% CI, 1.3%-15.1%), respectively.

“The FDA’s acceptance of our NDA with priority review marks an important regulatory milestone for our company,” Elcin Barker Ergun, chief executive officer of the Menarini Group, stated in a press release. “We look forward to working with the FDA during its review of this submission, which addresses a new potential therapeutic option for a major unmet need in the management of patients with advanced or metastatic breast cancer after resistance builds in the earlier lines of treatment.”

To participate on the EMERALD trial, patients must have progressed or relapsed on, or following, 1 or 2 lines of endocrine therapy for advanced disease, and one of these lines of treatment must have been given in combination with a CDK4/6 inhibitor. Patients also needed to have received at least 1 line of chemotherapy for advanced disease, and an ECOG performance status of 0 or 1.

Participants (n = 477) were randomly assigned 1:1 to receive daily elacestrant at 400 mg or investigator’s choice of SOC treatment in the form of fulvestrant (Faslodex), anastrozole, letrozole, or exemestane. They were stratified by 

 mutational status (yes vs no), previous fulvestrant exposure (yes vs no), and presence of visceral metastases (yes vs no).

-mutated tumors served as the co-primary end points of the trial. Secondary end points comprised overall survival (OS) in both populations, PFS and OS in those without 

mutations, investigator-assessed PFS, overall response rate, duration of response, clinical benefit rate, and safety.

Baseline characteristics were noted to be well balanced in the overall patient population. In the elacestrant and SOC arms, 29.3% and 31.5% of patients, respectively, received prior fulvestrant; 68.2% and 71 of patients, respectively, had visceral metastases.

Subgroup analyses showed that in the patients who did not previously receive chemotherapy in the metastatic setting (n = 371), the median PFS with elacestrant (n = 191) and SOC (n = 190) was 3.68 months (95% CI, 2.33-5.49) and 1.97 months (95% CI, 1.87-3.55), respectively (HR, 0.681; 95% CI, 0.520-0.891; 

-mutated disease who did not receive prior chemotherapy (n = 170), the median PFS with elacestrant (n = 89) was 5.32 (95% CI, 3.65-9.03) vs 1.91 months (95% CI, 1.87-3.71) with SOC (n = 81; HR, 0.535; 95% CI, 0.356-0.799; 

Elacestrant had a manageable toxicity profile that proved to be consistent with what has been reported with other endocrine therapies. Treatment-related adverse effects experienced by those who received elacestrant and did not receive prior chemotherapy included nausea (25.9%), fatigue (12.7%), and hot flush (11.1%). No treatment-related deaths occurred on either arm.

Menarini Group’s elacestrant granted priority review by the US FDA for patients with ER+/HER2- advanced or metastatic breast cancer. News release. Menarini Industrie Farmaceutiche Riunite. August 11, 2022. Accessed August 11, 2022. 

Bidard F-C, Kaklamani VG, Neven P, et al. Elacestrant (oral selective estrogen receptor degrader) versus standard endocrine therapy for estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: results from the randomized phase III EMERALD trial. 

. Published online May 18, 2022. doi:10.1200/JCO.22.00338

Kaklamani V, Bardia A, Aftimos P, et al. Subgroup analysis of patients with no prior chemotherapy in EMERALD: a phase 3 trial evaluating elacestrant, an oral selective estrogen receptor degrader (SERD), versus investigator’s choice of endocrine monotherapy for ER+/HER2- advanced/metastatic breast cancer (mBC). 

. 2022;40(suppl 16):1100. doi:10.1200/JCO.2022.40.16_suppl.1100

Elacestrant, an oral selective estrogen receptor degrader, will undergo evaluation by the FDA for patients with estrogen receptor–positive/HER2-negative advanced or metastatic breast cancer.

Oral Elacestrant Receives Priority Review Status for ER+/HER2– Advanced or Metastatic Breast Cancer

Avelumab (Bavenzio), erdafitinib (Balversa), and enfortumab vedotin-ejfv (Padcev) are 3 distinctly different drugs which have recently been added to the fold of available urothelial cancer therapies, explains Laura Wood, RN, MSN, OCN.

®, she details nurse-specific considerations of these 3 agents.

“We [have] several new treatment options,” Wood says.“No. 1 is avelumab—which is approved as a maintenance therapy. It’s the first and only maintenance therapy approved for individuals with advanced or metastatic urothelial cancer that [has] not progressed with frontline platinum containing chemotherapy. Nurses need to be aware that this treatment is available, that it is an approved option for patients who are doing well and benefiting from first line platinum-based chemotherapy.”

In addition, nurses should know that patients will require premedication for the first 4 doses of avelumab, which is unique to the other approved immune checkpoint inhibitors, she adds.

“The second drug that I talked about was erdafitinib, and that is approved for locally advanced or metastatic urothelial cancer where there's an 

This means biomarker testing is necessary, she says. Further, the drug is linked to an increased risk of elevated phosphorous levels. Nurses should be cognizant of this and educate patients about this potential adverse event (AE)—and potentially educating them about a low phosphorus diet as well.

The drug also has a unique dosing titration. “We start that drug at 8 mg once daily, which is [two] 4-mg tablets. If patients, after 14 to 21 days, do not have increase in their phosphorus levels, or other significant grade to AEs including ocular AEs, that dose can be increased to 9 mg, which is a 3-mg tablet, and 3 tablets taken once daily.”

Educating the patient about the unique dosing regimen is important, she says.

Finally, Wood highlights enfortumab vedotin. The drug’s recommended dose is 1.25 mg/kg.

The maximum dose is 125 mg/kg. It is administered intravenously over 30 minutes on days 1, 8, and 15, as part of a 28-day cycle.

“It is an antibody-drug conjugate that targets nectin-4 on the cell surface of your affiliate cancer cells,” Wood explains. “The drug binds to the Nectin-4, is taken into the cell where the linker of the drug and the drug conjugate is dissolved, [then] the microtubule payload is released and that leads to cancer cell apoptosis and death.”

Enfortumab vedotin may induce severe and fatal cutaneous AEs, including Stevens-Johnson syndrome and toxic epidermal necrolysis. These reactions frequently occur throughout the first treatment cycle but may also occur later.

Wood L. Novel approaches to renal and urothelial cancers. Presented at: 

 School of Nursing Oncology™; July 29-30, 2022; San Diego, CA.

Videos

Laura Wood discusses the successful integration of avelumab, erdafitinib, and enfortumab vedotin-ejfv into oncology nursing practice. 

Laura Wood on the Integration of Avelumab, Erdafitinib, and Enfortumab Vedotin into Urothelial Cancer Care

The FDA has approved betibeglogene autotemcel (beti-cel; Zynteglo) for adult and pediatric patients who require regular blood cell transfusions.

The single-dose treatment is the first approved cell-based gene therapy for this indication. Each treatment is customized using the patient’s own bone marrow stem cells. These are genetically modified to produce functional hemoglobin.

Two multicenter clinical trials supported the FDA’s decision. The primary end point for these trials was transfusion independence, which was defined as when a patient can maintain a pre-determined level of hemoglobin without needing a transfusion for at least 12 months. In these trials, among the 41 patients who received beti-cel, the rate of transfusion independence was 89%.

Patients who inherit the blood disorder beta-thalassemia have lower levels of hemoglobin and red blood cells in their system because of mutations in the bet-globin subunit. In return, insufficient levels of oxygen are delivered throughout the body, inducing dizziness, weakness, fatigue, bone abnormalities, and more serious complications. If a patient reaches transfusion-dependent status, they have reached the most severe form of the condition and they will require life-long red blood cell infusions every 2-5 weeks as standard treatment.

Unfortunately, life-long red blood cell transfusions come with risks, including problems in the heart, liver, and other organs because of excessive iron build-up in the body.

The mechanism of action behind beti-cel is intended to reduce the number of required transfusions for this population. The cell-based gene therapy works by adding functional copies of a modified form of the beta-globin gene into a patient’s own hematopoietic stem cells to allow them to make normal to near normal levels of total hemoglobin without regular transfusions.

“Transfusion-dependent beta-thalassemia is associated with an intense treatment burden and significant health risks related to regular red blood transfusions and iron management,” Alexis A. Thompson, MD, MPH, chief of the Division of Hematology, Children's Hospital of Philadelphia, said in a press release. “As a clinician and an investigator in the [beti-cel] clinical development program, I celebrate the therapeutic potential of this treatment for patients and its implications for the field of gene therapy, all made possible through the incredible courage of patients and families who participated in the clinical trials.”

Because the therapy is complex in nature, beti-cel will only be available at qualified treatment centers. These institutions will be selected based on their known expertise in areas including stem cell transplantation, cell and gene therapy, and beta-thalassemia. These centers will be given specialized training prior to being authorized to administer betibeglogene autotemcel. During administration, patients will need to be monitored for hypersensitivity reactions, thrombocytopenia, and bleeding.

The most common adverse events associated with treatment include reduced platelet and other blood cell levels, as well as mucositis, febrile neutropenia, vomiting, pyrexia (fever), alopecia (hair loss), epistaxis (nosebleed), abdominal pain, musculoskeletal pain, cough, headache, diarrhea, rash, constipation, nausea, decreased appetite, pigmentation disorder and pruritus (itch).

Investigators noted that there is a risk of blood cancer associated with this treatment strategy, however, this has not been observed with beti-cel. After undergoing treatment, patients should have their blood monitored for at least 15 years to assess for any evidence of cancer.

FDA approves first cell-based gene therapy to treat adult and pediatric patients with beta-thalassemia who require regular blood transfusions. News release. FDA. August 17, 2022. Accessed August 18, 2022. https://bit.ly/3C9Mpjh

bluebird bio announces FDA approval of Zynteglo the first gene therapy for people with beta-thalassemia who require regular red blood cell transfusions. News release. bluebird bio, Inc. August 17, 2022. Accessed August 18, 2022. https://bit.ly/3JZHSSx

Betibeglogene autotemcel is the first FDA-approved cell-based gene therapy to treat adult and pediatric patients with beta-thalassemia who need routine blood tranfusions. 

FDA Approves Single-Dose Betibeglogene Autotemcel for Patients With Beta-Thalassemia Who Require RBC Transfusions

The Transparency in Coverage Final Rule requires health care payers to unveil all previously secret negotiated prices with in-network providers.

Is a Health Care Price Transparency Revolution at Hand?

An ASCO expert panel conducted a comprehensive literature assessment to determine how diet, weight, and exercise play a role in defining patient outcomes.

ASCO Outlines Recommend Aerobic and Resistance Exercises for Patients Undergoing Active Cancer Treatment

Most patients who receive immunotherapies will experience few, if any, treatment-related adverse effects (AEs). But some patients receiving these treatments can experience serious AEs caused by an overactivation of the immune system and its effects on healthy cells.

Tackling the Adverse Events of Immunotherapy

Patients with treatment-naive extensive-stage small cell lung cancer showed encouraging clinical responses with pembrolizumab and etoposide after multiple years of follow-up.

3.5-Year Follow-Up Finds Pembrolizumab/Etoposide Combo Still Effective in Untreated ES-SCLC

The growing availability of biomarkers has led to the advent of more targeted therapies such as the antibody-drug conjugates (ADCs) fam-trastuzumab deruxtecan-nxki, ado-trastuzumab emtansine, and sacituzumab govitecan-hziy. 

Podsada Discusses Biomarker Testing and ADC Therapies in Breast Cancer 

Powerful chemicals used in chemotherapy may pose safety hazards for oncology nurses, pharmacists, and other health care providers if not handled properly.

USP <800>: Still a Work in Progress?

Phase 3 findings from the IMpower010 trial show that patients with resected non–small cell lung cancer may achieve an overall survival benefit with atezolizumab. 

Atezolizumab Signals OS Improvement in Patients with Resected NSCLC

Podcasts

Stephanie Jackson, DNP, MSN, RN, AOCNP, BMTCN, discusses the trajectory of targeted and CAR T-cell therapies such as ivosidenib and brexucabtagene autoleucel, and what nurses need to know about these treatments to be able to practice at the top of their licensure.

Stephanie Jackson Unpacks Recent Advances in Leukemia Treatments

Extended follow-up data from 2 trials confirmed that larotrectinib yielded positive progression-free and overall survival outcomes for patients with NTRK-positive lung cancer.

Larotrectinib Holds Ground as Effective Treatment in NTRK-Positive Lung Cancer

Phase 1 findings showed a 50% overall response rate among patients with EGFR-mutated non–small cell lung cancer who received amivantamab in combination with lazertinib plus carboplatin and pemetrexed.

Amivantamab/Lazertinib/Chemo Regimen Gains Traction in EGFR-Mutant NSCLC

Sherry Adkins, MSN, ANP-C, discusses some key considerations in ensuring quality patient care after they have completed CAR T-cell therapy at a specialized center.

Sherry Adkins Talks Primary Care Provider Communication Following CAR T-cell Therapy

The FDA has approved trastuzumab deruxtecan for patients with HER2-mutated non–small cell lung cancer after the DESTINY-Lung02 results demonstrated a 57% overall response rate with the agent. The drug comes with warning for interstitial lung disease, neutropenia, and left ventricular dysfunction. 

HER2-Directed Therapy, Trastuzumab Deruxtecan, Approved for Metastatic NSCLC

The FDA has granted capmatinib regular approval for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have a mutation leading to MET exon 14 skipping. The drug comes with warning for pneumonitis, hepatotoxicity, and pancreatic toxicity. 

Capmatinib Snags Full FDA Approval for MET Exon 14 Skipping NSCLC

In an unprecedented age of health care burnout, hospital administrators may
need to think outside of the box to find ways to engage and support employees.

Structured Onboarding Processes Boost Employee Retention 

Avelumab, erdafitinib, and enfortumab vedotin-ejfv are 3 critical drugs in the treatment of urothelial cancer with distinct safety profiles, according to a presentation at the 6th Annual School of Nursing Oncology™ Meeting. 

Top Medical News

Audiological Assessments May Be Vital Component of Cancer Survivorship Care Following Chemotherapy

Smith Discusses Evolving Landscape of Lymphoma Treatments

Oral Elacestrant Receives Priority Review Status for ER+/HER2– Advanced or Metastatic Breast Cancer

Laura Wood on the Integration of Avelumab, Erdafitinib, and Enfortumab Vedotin into Urothelial Cancer Care

FDA Approves Single-Dose Betibeglogene Autotemcel for Patients With Beta-Thalassemia Who Require RBC Transfusions

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