Underlying factors may contribute to cancer-related cognitive impairment and stress in patients undergoing active cancer treatment, according to research presented at the 47th Annual Oncology Nursing Society Congress.

Moreover, individual risk needs to be a continuous discussion between patients and providers, according to Kate Oppegaard, a second-year PhD student at the University of California San Francisco School of Nursing. Suring her presentation, she explained that previous research has demonstrated a relationship between 

 and anxiety; however, the interaction of the two is not often studied as such.

“We know that both cognitive impairment and 

anxiety occur in a significant percentage of patients with cancer

. And both of these symptoms lead to decrements in quality of life for patients,” Oppegaard said during the presentation. “However, these two symptoms are evaluated independently rather than together. Therefore, the purpose of this study is to identify groups of patients with distinct co-occurring cancer-related cognitive impairment and anxiety profiles, and then evaluated for differences in demographic, clinical and stress characteristics among these groups.”

The study included 1,332 outpatients with cancer during their first or second cycle of chemotherapy. Patients completed a demographic questionnaire, a performance status scale, a self-administered comorbidity questionnaire and their toxicity from chemotherapy was rated.

Compared to patients with high cognitive function and low anxiety (57%) — the lowest level of symptom burden — patients with moderate cognitive function and moderate anxiety (34%) were more likely: to be younger, female, Hispanic, living alone, unemployed and report childcare or elder care responsibilities, back pain and depression, and have a lower functional status and household income. Additionally, they were less likely to be married or have a partner.

Patients with low cognitive function and high anxiety (8%) — those with the most symptom burden — were more likely to be: younger, Hispanic, unemployed and report stomach disease or ulcers, as well as back pain and depression. These patients were less likely to be married or have a partner and exercise on a regular basis. They also had lower functional status and household income.

When evaluating perceived stress, there was a significant difference among the three groups of patients. Those with a higher symptom burden reported significantly higher levels of perceived global stress and cancer-related stress. Patients in the two higher symptoms burden groups met criteria for either post-traumatic symptomatology or post-traumatic stress disorder.

The final measure was to evaluate how a person felt that they could handle adversity, which is measured on a scale of zero to 40 with higher scores indicating a higher self-perceived resilience — the average score in the general population is 31.8, Oppegaard explained. The results demonstrated that patients with higher symptom burden had lower scores, meaning they had lower self-perceived resilience and were below the general population.

Oppegaard said that these results may help nurses and other clinicians identify patients who may be at higher risk of developing cancer-related cognitive impairment and stress.

“Many factors can contribute to cancer related cognitive impairment and 

. And future research is needed to understand how unrelieved stress may contribute to the co-occurrence of these two symptoms,” she concluded.

Oppegaard K, Miaskowski C, Cooper B, et al. Unrelieved Stress Contributes to Higher Levels of Co-occurring Cancer-Related Cognitive Impairment (CRCI) and Anxiety in Outpatients Receiving Chemotherapy. Presented at: 47th Annual Oncology Nursing Society Congress; April 27-May 1, 2022; Anaheim, CA. Abstract P286.

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Unrelieved stress may contribute to cancer-related cognitive impairment and anxiety in patients undergoing chemotherapy.

Study Seeks to Identify Connection Between Cognitive function and Anxiety In Patients Receiving Chemotherapy 

Older men with prostate cancer who have received androgen-deprivation therapy (ADT) may be at an increased risk of major averse cardiovascular events, including myocardial infractions, stroke, or death from any cause, according to data presented at the 47th Annual Oncology Nursing Congress.

ADT is often used as a treatment for patients with advanced prostate cancer. Nurses caring for patients receiving ADT may be aware to look out for a list of adverse events (AEs), including hot flashes, cognitive impairment, muscle wasting, and anemia. However, in recent years, providers have also begun to turn their attention to 

cardiac complications associated with this treatmen

Previous literature has demonstrated an association between the treatment and cardiovascular risk; however, there is still debate on whether ADT causes that risk or if it is other comorbidities, said Deborah Boldt-Houle, an author on the study and senior director of medical affairs at TOLMAR Pharmaceuticals, which manufactures the ADT therapy Eligard (leuprolide acetate), during the presentation.

This study, which included the medical records of 44,339 patients, evaluated the relationship between risk of major cardiovascular events and age in patients with prostate cancer on ADT. Patients included in the study were divided into age group: younger than 60 (6%); 60 to 70 years old (24%); 70 to 80 years old (39%); or 80 years or older (31%).

In the overall population, major averse cardiovascular events risk was between 2% and 6% one year after ADT initiation, and 12% and 31% four years after.

Additionally, risk of major adverse cardiovascular events was more common in older patients compared to younger patients in the first seven years after ADT.

Boldt-Houle added that these results are significant and a possible explanation for this is because older patients tend to have more comorbidities that could cause cardiovascular issues, such as diabetes, obesity and frailty, she explained.

The results highlight that a patient’s care team should be cognizant of their age and risk for major averse cardiovascular events prior to starting treatment with ADT. Future studies are needed to evaluate the role comorbidities play in cardiovascular problems during ADT.

Vandross J, Atkinson S, Boldt-Houle D. Risk of major adverse cardiovascular events after initiation of androgen deprivation therapy is higher for older patients.

Older men who have received androgen-deprivation therapy are an increased risk of heart issues, however, the root of the risk is still not well understood. 

Following ADT, Older Patients With Prostate Cancer Are at an Increased Risk of Cardiac Complications

Non-drug therapies such as cognitive therapies may be useful for cancer survivors experiencing insomnia. However, more research is needed to determine benefit in patients with advanced-stage cancer and those undergoing active treatment, according to results of a study presented at the 47th Annual Oncology Nursing Society Congress.

Eugenie Spiguel, a nurse practitioner in integrative medicine at Memorial Sloan Kettering Cancer Center in New York, explained that patients with cancer often experience insomnia at a rate of two or three times higher than the general population. And it is often treated with medication, which is not always suitable for patients who do not want an added mediation and the potential side effects that come along with it.

The American College of Physicians recommends cognitive behavioral therapy as first-line treatment for insomnia, and Spiguel sought to evaluate if this was an effective treatment option for patients with cancer based on previous studies.

cognitive behavioral therapy for insomnia

. The studies included methods such as group therapy, telemedicine and shortened versions of the typical visits for cognitive behavioral therapy (from six visits to two).

“By and large the findings were overwhelmingly positive, so there was an improvement in many insomnia parameters,” Spiguel said during the presentation. Improvements were observed in the time it took to fall asleep, the ability to stay asleep and waking up early.

 and not patients currently undergoing treatment.

“And that is unfortunate only in that we already know that it’s effective in the general population, (and) the survivorship population coincides with that,” she said. Spiguel hopes that patients undergoing active treatment can be included in future studies.

“I would love to see more research done on patients who are undergoing treatment or in the advanced cancer (stage) population,” she added.

She concluded in saying that treating insomnia in patients with cancer is easy to implement into daily practice and is rewarding.

“If we find that patients are having insomnia, we can easily intervene with a non-drug therapy. I do this myself in my own clinic and it is extremely rewarding to see somebody improve, to see their insomnia really get better,” Spiguel concluded.

Spiguel E. Cognitive behavioral therapy for insomnia comorbid with cancer. Presented at: 47th Annual Oncology Nursing Society Congress; April 27-May 1, 2022; Anaheim, CA. Abstract P313.

Cognitive therapies were found to be effective for helping cancer survivors with insomnia, but more research is needed for patients actively receiving treatment. 

Cancer Survivors Struggling With Insomnia May Benefit from Cognitive Therapy 

Patients with advanced metastatic renal cell carcinoma (mRCC) can safely begin cabozantinib (Cabometyx) immediately after receiving immunotherapy (IO) combinations without inducing new safety signals, according to data presented at the 2022 Genitourinary Cancers Symposium.

Viktor Grüwald, MD, PhD, who presented the findings and professor of interdisciplinary genitourinary oncology at the University Hospital in Essen, Germany, explained that these data are similar to prior clinical results, such as from the METEOR study (NCT01865747) from 2016, and confirm the use of cabozantinib in this setting.

“What we have seen is that it’s quite confirming that even … our real-world population was really coming close to the efficacy data that we have seen in the METEOR study, and that’s something that I think is quite compelling in terms of the role of cabozantinib after the failure of immuno agents. Because there is just scarce data, it is important to see that the recommendations that we gave in guidelines are quite supported. They’re supported by our data actually,” he said in an interview with 

Grünwald explained that data on cabozantinib after IO combinations in mRCC still remains scarce, so he and researchers further evaluated the safety and efficacy of cabozantinib after IO-based therapy with a primary endpoint of the incidence of serious adverse events (SAE).

With a cutoff date of October 8, 2021, the final analysis included 56 eligible patients (71.4% male) with a median age of 66 years. There were 87.5% of patients (n = 49) who had a nephrectomy, 66.1% (n = 37) had clear cell RCC and 89.3% (n = 50) had 2 or more previous lines of therapy.

The usual dosing of cabozantinib is 60 mg, and 62.5% (n = 35) of patients started at a reduced dose at the start of treatment, 55.4% (n = 31) required a dose reduction during treatment and 1.8% (n = 1) discontinued treatment during this study. The median treatment duration was 6.1 months. During this time, 10.7% (n = 6) of patients had a partial response, 19.6% (n = 11) had stable disease and 12.5% (n = 7) had progressive disease.

Overall survival (OS) and progression-free survival (PFS) were assessed from the start of therapy, and researchers compared these data with 20 patients who had a starting dose of 60 mg (cohort A) to those receiving less than 60 mg (cohort B) in a post-hoc analysis.

Results demonstrated the median OS and PFS of 15.34 months (95% CI; 8.94, 20.93) and 6.34 months (95% CI, 5.29-8.25) in the intention-to-treat population, respectively. In addition, median OS and PFS in cohort A were 10.48 months (95% CI, 6.01-34.14) and 6.51 months (95% CI, 2.99-10.87. In cohort B, median OS and PFS were 16.46 months (95% CI, 9.56-23.33) and 6.34 months (95% CI, 4.86-8.71).

“The data that we generated is clinically meaningful because it is a common practice and our data supports the current clinical practice,” Grünwald added. “… I think it reassures the role of cabozantinib. Something that it brings up is the role of the dose of cabozantinib, of course, and as it appears, even in the METEOR study, about half of the patients needed some dose reductions and the median dose was about 40 milligrams. So at the end of the day, I think 40 milligrams is a good starting point for cabozantinib.”

Additionally, those who started on the lower dose experienced fewer side effects compared to those who started on 60 mg. All grade AEs and grade 3-5 AEs occurred in 87.5% (n = 49) of patients and 44.6% (n = 25) in ITT. In cohort A, all-grade AEs and grade 3-5 AEs occurred in 95% (n = 19) of patients and 55% (n = 11), respectively.These also occurred in 85.7% (n = 30) and 40% (n = 14) of patients in cohort B.

In addition, SAEs were reported in 21.4% (n = 12) of patients from the entire study, including 30% (n = 6) from cohort A and 17.1% (n = 6) in cohort B. Treatment-related SAEs occurred in 10.7% (n = 6) of patients in this study, including 15% (n = 3) of those in cohort A and 8.6% (n = 3) in cohort B.

“Overall, it’s well tolerated and well manageable. … We don’t have any additional safety signals here. And it is similar to what we have seen in other studies actually in terms of safety profiles. So nothing unexpected,” he explained.

Gründwald said the main point here is that the data supports the use of cabozantinib after IO failure as it is safe a feasible, and the only thing that will need further research is dose reduction.

“Our data really supports the use of cabozantinib after IO failure. I think that's the main message. It's safe, tolerable and it’s efficacious,” he concluded. “It supports the use of 40 (mg) as well as 60 (mg), and that I think is a novelty because 60 mg is the licensed dose for the use of cabozantinib vs. single agent.”

Grünwald, V, Boegemann M, Rafiyan M-R, et al. Final analysis of a non-interventional study on cabozantinib in patients with advanced renal cell carcinoma after prior checkpoint inhibitor therapy (CaboCHECK).

 2022;40(suppl 6):357. doi: 10.1200/JCO.2022.40.6_suppl.357

Cabozantinib is determined to be a safe treatment option for patients with metastatic renal cell carcinoma whose disease failed to respond to prior immunotherapy combinations. 

Cabozantinib Validated as Safe Post-Immunotherapy Option for Patients with mRCC

Findings presented at the 22nd Annual Meeting of the Society of Urologic Oncology demonstrated that patients with localized prostate cancer (PCa) and a body mass index (BMI) equal to or greater than 33 kg/m

 were less likely to undergo surgery (RP) as a treatment modality.

Nathan Samora—who presented the results and is a fourth-year medical student at Vanderbilt University School of Medicine—and fellow researchers sought to study the association between BMI and treatment modality as well as patient-reported outcomes after therapy.

The researchers found that men who were younger, less-educated, Black or had more comorbidities were more likely to be obese (

 <.001). Additionally, there was no significant difference in PCa risks across BMI groups.

Results demonstrated a linear increase in the likelihood of receiving an RP as the BMI increased from 18 to 28 and there was a linear decrease of receiving an RP thereafter. This became statistically significant at a BMI of greater than or equal to 33, Samora said. At no BMI was the likelihood of receiving active surveillance (AS) statistically significant.

Additionally, it was found that obese men have worse sexual function at baseline and all other time points throughout the 5 years; however, it was observed that trajectories between normal weight and overweight men are highly similar.

After adjusting for disease specifications between obese and non-obese men, it was found that there were not clinically important differences in patient-reported outcomes for men who underwent definitive treatment.

Results also demonstrated that men who were obese and on active surveillance had worse urinary incontinence compared with non-obese peers at 6 months and through the 5 years.

Patients (n = 2378) included were from the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) Study and were mostly White (77%), with a median age of 64 years and a median BMI of 27 kg/m

. Patient-reported quality of life was measured at enrollment and 6, 12, 36, and 60 months using the 26-item Expanded Prostate Index Composite (EPIC-26).

1. Samora, N, Wallis, C, Tallman, J, et al. Association between BMI and localized prostate cancer treatment modality and patient-reported outcomes. Presented at: Society of Urologic Oncology 22nd Annual Meeting; November 30-December 3, 2021; Orlando, FL. Abstract 105.

Researchers identified a linear decrease in the likelihood of surgery once patients with localized prostate cancer reached a BMI of 33 or greater.

High BMI in Localized Prostate Cancer Associated With Decreased Likelihood of Undergoing Surgery

Results presented at the 22nd Annual Meeting of the Society of Urologic Oncology indicate that the rates of upgrading and adverse pathology at radical prostatectomy cancer are similar in Hispanic and non-Hispanic men with prostate cancer.

“Hispanics are the largest ethnic minority and one of the most rapidly growing populations in the United States and prostate cancer is the highest incident non-cutaneous malignancy in this population,” said Helen Y. Hougen, MD, SUO fellow at the University of Miami, during a presentation of the findings. However, compared with other well studied populations, such as White non-Hispanic or Black men, the Hispanic or Latino population as a whole has been studied to a lesser extent, either it's combined with disparate groups or excluded altogether.”

Researchers sought to examine a rate and pattern of upgrading (any increase in Gleason grade [GG] from biopsy to prostatectomy) and adverse pathology (extraprostatic extension, seminal vesicle invasion, lymph node-positive) in Hispanic patients using an institutional prostatectomy database, specifically in the south Florida region.

Previously, the SEER database has demonstrated there are similar survival outcomes between Hispanic and White patients with prostate cancer; however, this database does not include South Florida—which has a high population of Hispanic men.

Patients included in the study were non-Hispanic White (NHW; n = 688), Hispanic White (HW; n = 736), and Black (n = 426) men who underwent a radical prostatectomy between 2014 and present. There was no significant difference in age, body mass index (BMI), prostate-specific antigen (PSA), prostate size, or biopsy GG between groups.

Results demonstrated that 651 patients had upgrading, and it was not different between groups.

On the univariable analysis, patients who were Black had a lower rate of adverse pathology compared with patients who were White. Hougen explained this may be because the Black population in south Florida has a greater number of men who are of Caribbean decent, not of African origin.

In the multivariable analysis, significant predictors for upgrading included older age, higher PSA, and lower prostate weight. And there were no differences observed between the three groups and the rate of upgrading.

Adverse pathology odds increased with older age, higher PSA, higher BMI, lower prostate weight, increased number of biopsy cores, and higher GG.

“Hispanic (patients) are more negatively impacted by socioeconomic factors, such as neighborhood effects, compared (with White patients). However, despite this, they have similar survival compared with white (patients) suggesting an at least equal, if not more favorable, cancer characteristic,” Hougen concluded.

Hourgen H, Iakymenko O, Punnen S, et al. Race is not associate with prostate cancer upgrading in Hispanic men undergoing radical prostatectomy. Presented at: Society of Urologic Oncology 22nd Annual Meeting; November 30-December 3, 2021; Orlando, FL. Abstract 148

Hispanics are the largest ethnic minority and one of the most rapidly growing populations in the United States. Prostate cancer represents the highest incident non-cutaneous malignancy in this population.

Rates of Upgrading, Adverse Pathology Similar in Hispanic and White Non-Hispanic Men With Prostate Cancer

Yoga can promote an improved quality of life among patients with prostate cancer, show phase 2 trial findings presented at the 2021 AUA Annual Meeting. In addition, the meditative activity may result in antitumor immune responses and reduced inflammation in patients undergoing prostatectomy.

Yoga has a direct effect on the vagus nerve, which can shape how a person thinks, remembers, and feels. And patients with prostate cancer have a 20% to 30% incidence and prevalence of depression and anxiety.

In previous studies, yoga has demonstrated an improved quality of life for patients with cancer, as well as lower inflammation. Additionally, newer, emerging data has demonstrated that mindfulness exercises, such as yoga, can cause the frontal and limbic parts of the brain to structurally change.

“However, if you look at hierarchy of evidence, most data on immune benefits of yoga is from small series and case reports, no such data exists for prostate cancer. Given these findings of improvement in quality of life with yoga, we started looking at [the] role of yoga in prostate cancer,” said Dharam Kaushik, MD, associate professor in the department of urology at the University of Texas Health, San Antonio, during the presentation of the data.

The primary outcomes of this clinical trial [NCT02620033] was self-reported outcomes of quality of life at baseline, and 6 weeks. Secondary outcomes included immune cell status and cytokine levels, also at baseline and 6 weeks.

“We wanted to evaluate the quality of life from multiple vantage points, therefore we utilized 4 different quality of life questionaries,” Kaushik mentioned. Self-reported outcomes were assessed by the Expanded Prostate Index Composite (EPIC), Functional Assessment of Cancer Therapy-Prostate (FACT-P), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Five Facets of Mindfulness Questionnaire (FFMQ).

The study consisted of 30 men who were newly diagnosed with localized prostate cancer and scheduled for a radical prostatectomy. Patients were randomized to either yoga (n = 15) or standard of care (n = 15). And patients in the yoga group, performed the activity for 60 minutes twice a week for 6 weeks before their prostatectomy and 3 to 6 weeks after.

Yoga “meaningfully” improved EPIC-sexual scores, FACIT-F, FACT general and FACT-P. In substratification, there were improvements in sexual, physical, and social well-being in the yoga group.

Additionally, participants in the yoga group demonstrated increased numbers of CD4+ (

There was also an increase in the natural killer cells IFNNK (

 = .041), “indicating a robust immune response,” Kaushik added.

Yoga also had an enhanced effect on antitumor activity, decreasing the numbers of regulator T-cells and myeloid-derived suppressor cells: CD11b+CD33+ (

There was also a decrease in cytokine cells including, G-CSF (

 = .032), which had shown to activate production endothelial cell and cytokines. Additionally, there was a decrease in MCP-1 (

 = .044), which are associated with proception against dementia, and FLt-3L (

 = .053) which has been linked to reducing chronic inflation, Kaushik mentioned.

The benefits demonstrated in this study require further investigation, the authors concluded in the abstract.

Kaushik D, Shah P, Mukherjee N, et al. A phase 2 randomized clinical trial of yoga in men with prostate cancer. Presented at: 2021 American Urological Association Annual Meeting; September 10-13, 2021; virtual. Abstract LBA02-03.

Yoga has a positive impact on the vagus nerve, which influences how people think, remember, and feel, and therefore can improve the mental well-being of patients with prostate cancer. 

Yoga Encourages Antitumor Response, Boosts Quality of Life in Patients with Prostate Cancer 

Retevmo (selpercatinib) demonstrated response improvements in previously treated patients with 

 fusion-positive non-small cell lung cancer (NSCLC), according to findings presented at the virtual 2021 ASCO Annual Meeting.

“However, results should be interpreted with caution, as a limitation of this analysis was that immediate prior response assessment was based on physician-reported best response in patients’ medical history and may not follow RECIST criteria,” the researchers said.

This study consisted of 218 evaluable patients (median age 61 years) who previously received platinum-based chemotherapy. The majority had an ECOG (or the measurement to describe a patient’s level of functioning in terms of ability to care for themselves, daily activity and physical ability; with zero being fully active and four being disabled) of 0/1, with an average of two (range: 1-15) prior systematic therapies, across 89 sites in 16 countries.

The primary endpoint of the study was objective response rate (or the rate of a measurable response to the treatment), with secondary endpoints of progression-free survival (time during and after treatment when the patient lives without disease progression), duration of response (or the length of time that a tumor continues to respond to treatment without the cancer growing or spreading) and safety.

The study compared each patient’s best overall response to their prior therapy to the response elicited from Retevmo.

The objective response rate with Retevmo was 57% which was “markedly higher,” the researchers wrote, than responses for prior treatment at 16%.

A total of 108 patients (50%) did not respond to prior therapy but did respond to Retevmo. There were 16 patients (7%) who responded to both Retevmo and prior therapy, 18 patients (8%) who responded to prior therapy but not Retevmo and 76 patients (35%) who did not respond to either.

Objective response rate was improved regardless of prior therapy, chemotherapy plus immune checkpoint inhibitor (57% versus 14%), single-agent immune checkpoint inhibitor (48% versus 3%) or chemotherapy (58% versus 15%).

Fewer patients had progressive disease with Retevmo best overall response (2%), compared with immediate prior therapy (28%). Median duration of response was also longer compared with prior therapy, with an average of 11.8 months versus 3.4 months.

“A global, randomized, phase 3 trial (LIBRETTO-431; NCT04194944) evaluating (Retevmo) compared with standard frontline therapy (Altima/ carboplatin with or without Keytruda) is ongoing,” the researchers concluded.

For more news on cancer updates, research and education, don’t forget to 

Previously treated patients with non-small cell lung cancer tended to have better responses with Retevmo than they did with prior treatments. 

Retevmo Shows Improvement for Previously Treated Patients With Non-Small Cell Lung Cancer 

Pralsetinib (Gavreto) elicited promising responses and tolerability in patients with 

 fusion-positive non-small cell lung cancer (NSCLC), including those who were not eligible for platinum-based therapy.

“These data are real important because it supports the importance of early biomarker testing for all patients with metastatic NSCLC prior to treatment initiation to inform optimal healthcare decisions,” said Giuseppe Curigliano, MD, PhD, associate professor of medical oncology at the University of Milano in Italy and head of the division of early drug development at the European Institute of Oncology in Italy, at the 2021 virtual ASCO Annual Meeting about updated data from the ARROW trial.

The phase 1/2 study was conducted at 84 sites in 13 countries. In particular, the safety population for this study included 233 patients with 

 fusion-positive NSCLC and 238 patients with other RET-altered solid tumors. In particular, 216 patients (median age, 60 years; 48% men) with 

fusion-positive NSCLC had measurable disease.

Originally patients who were treatment-naïve were not eligible, which was a requirement that was later removed by a protocol amendment. There were 25 patients who were enrolled after this eligibility revision (median age, 54 years; 44% men).

The study had a primary endpoint of objective response rate (ORR). Follow-up was conducted for a median of 17.1 months.

For the 216 patients who received pralsetinib and were 

 fusion-positive, the ORR was 69% (95%, CI, 62-75), DCR was 92% (95%, CI; 87-95), CBR was 77% (95%, CI; 71-82) and median DoR was 22.3 months (95%, CI; 15.1-not reached).

In the post-eligibility population with 25 patients, the ORR was 88% (95% CI, 69-98), CBR was 88% (95% CI, 69-98), DCR was 96% (95% CI, 80-100). In addition, median DoR and median PFS was not reached.

“The most important observation is that in the expansion cohort of real-world and first-line treatment of (non-small cell lung cancer) patients with 

fusion-positive tumor, the overall response rate was 88%, providing support for RET inhibitor as a first-line standard of care because the response rate was better in this population (with) respect to the previous eligibility criteria population,” Curigliano said.

The median duration of response in patients with prior platinum-based chemotherapy was 22.3 months (95% CI, 15.1-not reached). Curigliano added that it was too early to analyze data regarding the duration of response in treatment-naïve patients.

Overall, 26 patients (6%) out of 471 patients in the entire study discontinued treatment due to treatment-related adverse events. In all tumor types, 15% of patients had treatment-related neutropenia leading to treatment interruption whereas 14% had neutropenia from the treatment which resulted in a dose reduction. Less than 1% of patients discontinued treatment from treatment-related neutropenia.

“It means that pralsetinib was very well tolerated,” Curigliano said.

Curigliano, G, Gainor JF, Griesinger F, et al. Safety and efficacy of pralsetinib in patients with advanced RET fusion-positive non-small cell lung cancer: Update from the ARROW trial. Presented at: 2021 ASCO Annual Meeting; June 4-8, 2021; Virtual. Abstract 9089.

Pralsetinib elicited promising responses and tolerability in patients with RET fusion-positive non-small cell lung cancer (NSCLC), including those who were not eligible for platinum-based therapy.  

 Pralsetinib Is Tolerable, Durable in RET Fusion+ NSCLC

Virtual visits from cancer care coordinators with veteran colon cancer survivors decreased anxiety and improved patients’ satisfaction during the COVID-19 pandemic, according to a virtual poster presentation at the Oncology Nursing Society Congress.

Due to social distancing requirements during the COVID-19 pandemic, many veterans who are cancer survivors experienced changes in treatment protocols and schedules. This resulted in higher levels of stress and anxiety about changes in their outcome and survival, on top of stress about their cancer diagnosis, noted Janice Schwartz, MSN, OCN, RN, an oncology certified nurse at the New Mexico VA Healthcare System, said during the presentation.

“As a cancer care coordinator, my role morphed abruptly in March 2020. I was faced with calling veterans living with a cancer diagnosis to advise them of cancelled procedures, visits and surgeries due to the COVID-19 pandemic. I found veterans living with a cancer diagnosis were experiencing new stressors. Already experiencing anxiety related to the diagnosis of cancer that we are all familiar with, they now face limitations of [COVID-19] further impacting their lives.”

Providers found a new way to connect with this population to improve communication through virtual visits to potentially decrease stress about COVID-19 and improve patients’ satisfaction regarding their survivorship care.

“I have found maintaining visual contact with a veteran allows them to feel connected, to know that we are still here for them and has improved patient’s satisfaction,” Schwartz said.

Prior to the virtual appointments, veterans were emailed instructions on how to use the platform and scheduling on a personal laptop, tablet, computer or smartphone. Upon completion of the appointment, they were emailed a survey, of which 100% were returned.

During the virtual appointments, veterans were given reassurance regarding cancer treatment and recommendations, in addition to COVID-19 safety measures and processes to decrease possible exposure.

A total of 95% of the veterans reported an overall decrease in anxiety after the virtual appointment. The appointments decreased COVID-19 related stress in 90% of veterans and led to improved patient satisfaction in 96% of veterans.

The virtual appointments resulted in the following:

overall convenience (less time off work, avoidance of travel and expenses, not having to search for parking and ability to stay safely at home),

decreased anxiety (decreased post-traumatic stress disorder symptoms, less worry and less nervousness),

decreased stressors (ability to stay safety at home, understanding safety measures implemented in the hospital and review of recommended)

and improved satisfaction (personalized visit vs. phone call, ability to see their chart and reports through shared screen options and requested to have virtual post COVID-19).

Limitations of the virtual appointments included requiring an electronic device with a camera, connection to internet, Apple misfunctions, remembering usernames and passwords.

“I’ve learned by saying that perhaps if we look to the end of the rainbow and search for the silver lining of [COVID-19], we would see the many advances in care such as virtual platforms that will continue to improve care and decrease barriers for our veterans long after [the COVID-19 pandemic],” Schwartz concluded.

Schwartz J, Valdez-Boyle L. Colorectal Cancer Survivorship: Enhancing Communication During COVID-19 Through Cancer Care Coordinator Virtual Visits in the Veterans Healthcare System. Presented at: Oncology Nursing Society 46th Annual Congress. April 20, 22, 27 & 29, 2021. Virtual.

Due to the COVID-19 pandemic, many patients’ and survivors’ care has changed, but one nurse and her team sought to make this population more comfortable and safe during these times with virtual visits.

Colleen Moretti