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Biomarker data from CodeBreaK 300 suggest DNA and RTK pathway alterations may underlie resistance to sotorasib plus panitumumab in CRC.

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Michelle Kirschner, RN, MSN, ACNP, APRN-BC, is a nurse practitioner and director of program development at the Cancer Survivorship and Supportive Care Professionals Network.

Bridget Hoyt is the assistant editor for Oncology Nursing News. She earned her BA in communication studies at Rider University with a minor in public relations. She can be reached at 

The BCI and patient goals help oncology nurses counsel patients on endocrine therapy use after 5 years, per Michelle Kirschner RN, MSN, ACNP, APRN-BC.

BCI, Patient Preference Guide Nurses in 5-Year Endocrine Counseling

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Prior to joining MJH Life Sciences, she worked at Gannett as a full-time reporter with the Asbury Park Press. Email: gmauro@onclive.com

Adding danazol or erythropoiesis-stimulating agents for anemia management to a ruxolitinib regimen for myelofibrosis does not decrease treatment efficacy.

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Stacey Hield, BSN, RN, OCN, is a regional director at the American Oncology Network.

Read Stacey Hield, BSN, RN, OCN's recommendations for best use of durvalumab in non-small cell lung cancer.

Rx Road Map: Durvalumab for Non-Small Cell Lung Cancer

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Keeping a positive outlook is proven to help with stress management, but when someone says to "think positive" or "be optimistic" during a time such as a cancer diagnosis, it can be much easier said than done. We know that cancer isn't all rainbows and butterflies, and once a patient enters a dark mindset, it can be hard to get out of it. But most of us have that one message of hope and inspiration that somehow manages to help bring some perspective and optimism to a situation.

You beat cancer by how you live, why you live, and in the manner in which you live

. — Stuart Scott. Live your life by your own terms, not cancer's.

Remember how far you've come, not just how far you have to go. You may not be where you want to be, but neither are you where you used to be

. It can be easy to get caught up in how far you have to go. Don't forget to look back, and recognize how far you have come. Every day brings you one step closer.

You are braver than you believe, stronger than you seem, smarter than you think, and twice as beautiful as you'd ever imagined

. Don't let cancer cause you to sell yourself short or forget your worth.

When you have exhausted all possibilities, remember this: You haven't

. —Thomas Edison. Keep searching for what you're looking for. You will find it.

Your life is your story. Write well. Edit Often

. You can't control what happens to you, but you can control the way that you handle it. What do you want your story to say?

. You are here, breathing and living life. Even if it's not the life you want or hoped for, it's life. There's always something to be thankful for.

. Every small step counts. You might not reach your goal today but that is okay.

Never be ashamed of a scar. It simply means you were stronger than whatever tried to hurt you

. Everyone has scars—whether you can see them or not. Wear yours with pride.

When it rains, look for rainbows. When it's dark, look for stars

. It may be hard to find your silver lining during a cancer diagnosis, but it's there. If you look for it, you will find it.

Optimism: someone who figures that taking a step backward after taking a step forward is not a disaster; it's more like a cha-cha. 

You may not be where you want to be right now, but you're just doing the dance that is called life.

I have loved the stars too fondly to be fearful of the night

. — Galileo. If you loved your life before cancer, do not be afraid of life after cancer. You will find beauty again.

Surround yourself with only people who are going to lift you higher

. — Oprah Winfrey. There is no time for negative energy during cancer .You need to be around people who inspire, challenge, and make you better.

. The bad thoughts will try and sneak in, but don't let them. Focus only on the good thoughts.

Don't look back. You're not going that way

. Don't waste time worrying about the things that you cannot control; such as the past. Keep moving forward.

. There's no other option. Tell yourself this affirmation every day - through treatments, doctors visits, and whatever else comes your way.

. You are not defined by what you are going through. Cancer will never have you. You are much more than your disease.

. Cancer is NOT a death sentence. It's just one word in your sentence; one part of your life.

. Nobody's perfect. If you feel broken, don't let that determine your worth. You can still do so much.

It is often in the darkest skies that we see the brightest stars. 

Try and find some beauty in your situation. You won't be the person you were before cancer, but that does not have to be a bad thing. 

For patients dealing with cancer, a daily dose of inspiration may make a big difference in their outlook on life. 

Survivorship

20 Inspirational Quotes for Cancer Survivors, Fighters, and Caregivers

The FDA approved the use of daratumumab and hyaluronidase-fihj (Darzalex Faspro) for patients who are newly diagnosed with multiple myeloma and are eligible for autologous stem cell transplant. In this patient population, daratumumab and hyaluronidase-fihj is given with bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone; this regimen is known as D-VRd and will be used as induction as well as consolidation leading toward the transplant.

The FDA approval is supported by data from the PERSEUS study (NCT03710603), which involved 709 patients who were randomly assigned to receive either the standard VRd regimen (bortezomib, lenalidomide, dexamethasone) or the daratumumab-enhanced regimen (D-VRd).

 The new, enhanced regimen of D-VRd achieved a 60% reduction in disease progression or death compared with the standard VRd.

 It also resulted in a deeper response at the end of consolidation, which could significantly delay disease progression. This latest quadruple therapy, D-VRd, is given as a first line of treatment when patients are likely to experience deeper responses, offering hope for patients with multiple myeloma who are transplant eligible.

Daratumumab (Darzalex) is a human immunoglobulin G1 k (IgG1k) monoclonal antibody designed to bind to CD38 proteins in multiple myeloma cells and activate immune cells, such as natural killer cells and macrophages, to attack and destroy myeloma cells. It essentially directly kills myeloma cells and/or enables the immune system to recognize and terminate them. Hyaluronidase is an enzyme that helps antibody IgG1k reach the target, protein CD38. When the medication is administered, this enzyme breaks down the subcutaneous tissue surrounding the injection site. Permeability of the tissue is restored within 24 to 48 hours.

How It’s Administered and the Recommended Dose

This treatment requires the following premedications: oral acetaminophen (Tylenol), diphenhydramine plus phenylephrine (Benadryl), and intravenous or oral corticosteroids.

 The prescribing physician will determine the dose and route of the premedications, along with the wait time (usually between 1 and 3 hours).

Daratumumab and hyaluronidase-fihj is a subcutaneous injection given in the abdomen. Nurses should choose a site approximately 3 in (7.5 cm) to the right or left of the patient’s navel. The standard dose for every patient is 1800 mg of daratumumab and 30,000 units of hyaluronidase per 15 mL. The entire 15 mL is given by a slow push over 3 to 5 minutes.

Hypersensitivities: These can be observed, especially after the first and second dose. Please follow your facility’s protocol for systemic allergic reactions (severe or life-threatening) and consider symptomatic management for local reactions (erythema, itching).

Neutropenia and thrombocytopenia: Monitor the patient’s complete blood cell count with differential and consider withholding the treatment until the count recovers.

Embryo-fetal toxicity: Female patients with reproductive potential should use effective contraception both while on treatment with daratumumab and hyaluronidase-fihj and for 3 months following treatment.

Interference with serological testing: Treatment with daratumumab and hyaluronidase-fihj could interfere with red blood cell antibody screening or cross-matching, so patients should be typed and screened before initiating therapy. Additionally, blood banks should be told whether a patient has received daratumumab and hyaluronidase-fihj. These serological changes can be seen up to 6 months after treatment.

What to Inform Patients About to Start Treatment

The most common adverse effects reported include nausea, fatigue, upper respiratory infections, and constipation. Coldlike symptoms and fatigue are very common, but any fever of 100.4 °F (38 °C) or higher should be reported to the provider.

Teach your patients about pancytopenia. The patient will be taking an oral corticosteroid for up to 2 days post treatment to reduce the risk of delayed reactions. Reaction times typically range from 4 minutes to 3.5 days. Please inform the patient when to seek medical attention. Some patients may need antiviral medications to prevent herpes zoster reactivation. Hepatitis B reactivation can also occur; please check the patient’s medical history or obtain a hepatitis B panel.

Advice for Nurses Who Administer This Agent

The injection will take 3 to 5 minutes—to protect your back, sitting down is strongly encouraged.

For successive injections, injection sites should be rotated. Avoid injecting into red, hard, bruised, scarred, or tender skin. The rate of injection should be slowed if a patient is in pain. Daratumumab and hyaluronidase-fihj should not be given alongside other subcutaneous treatments.

Use recommended personal protective equipment while administering the drug.

Darzalex Faspro (daratumumab and hyaluronidase-fihj)-based quadruplet regimen approved in the U.S. for patients with newly diagnosed multiple myeloma who are transplant-eligible. Johnson & Johnson. July 30, 2024. Accessed April 30, 2025. https://www.jnj.com/media-center/press-releases/darzalex-faspro-daratumumab-and-hyaluronidase-fihj-based-quadruplet-regimen-approved-in-the-u-s-for-patients-with-newly-diagnosed-multiple-myeloma-who-are-transplant-eligible

Sonneveld P, Dimopoulos MA, Boccadoro M, et al. Daratumumab, bortezomib, lenalidomide, and dexamethasone for multiple myeloma. 

. 2024;390(4):301-313. doi:10.1056/NEJMoa2312054

Darzalex Faspro. Prescribing information. Janssen Biotech Inc; 2024. Accessed April 30, 2025. https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/DARZALEX+Faspro-pi.pdf

Darzalex Faspro patient tips. Drugs.com. Updated August 7, 2024. Accessed April 30, 2025. https://www.drugs.com/tips/darzalex-faspro-patient-tips

A registered nurse gives best practices for use of subcutaneous daratumumab in multiple myeloma.

Rx Road Map: Subcutaneous Daratumumab in Multiple Myeloma

Less inflammatory diets were significantly linked to an overall survival (OS) benefit but did not significantly increase disease-free survival (DFS) for patients with surgically resected stage III colon cancer, according to findings from a secondary analysis of the phase 3 CALGB/SWOG 80702 trial (NCT01150045) presented at the 2025 American Society for Clinical Oncology Annual Meeting.

Investigators assessed the diets of 1625 patients using the empirical dietary inflammatory pattern (EDIP) scoring guide following the completion of 2 dietary questionnaires at different points of the study to place patients into quintiles by inflammatory levels of their diets. Patients in the highest quintile (indicating a more inflammatory diet) had an 87% higher risk of death compared with the lowest quintile (multivariable hazard ratio [HR], 1.87; 95% CI, 1.26-2.77; 

 = .01). Those in the highest quintile had a median OS of 7.70 years, while median OS was not reached in the lowest quintile.

“Our study showed that greater intake of a pro-inflammatory diet pattern is associated with worse overall survival in patients with stage III colon cancer,” detailed Sara K. Char, MD, of Massachusetts General Hospital, Boston, Massachusetts, in her presentation at the meeting.

While an unadjusted model showed a greater trend toward DFS for the lowest quintile, which had a median DFS of 7.21 years, vs those in the highest quintile, which had a median DFS of 6.81 years (HR, 1.46; 95% CI, 1.08-1.97; 

 = .06), a multivariable-adjusted model demonstrated that this difference was not statistically significant (HR, 1.36; 95% CI, 0.99-1.86; 

Regarding patient subgroups, the use of anti-inflammatory medications like aspirin and celecoxib yielded no significant difference in OS (

To provide an additional metric on the effect of systemic inflammation on survival, researchers divided patients into groups of those with higher physical activity levels with a cutoff of 9 MET-hours per week. As Char explained, 9 MET-hours equates to approximately 30 minutes of “vigorous walking” 5 days a week along with light yoga.

“We wanted to examine the joint effect of physical activity and diet on overall survival, as we know that both can impact systemic inflammation,” explained Char in her presentation.

Those with lower levels of physical activity and diets in the highest through second lowest quintiles of inflammatory diets had a 63% higher risk of death compared with those in the same EDIP categories but with higher physical activity levels (95% CI, 0.25-0.53; 

In Char’s presentation, she mentioned that data also presented at the conference further validates the efficacy of exercise in prolonging survival for patients with stage III colon cancer.

Findings from the phase 3 CHALLENGE trial (NCT00819208) demonstrated that enrolling patients in a 

 yielded an 8-year OS rate of 90% and lowered the risk of death in patients with stage III or high-risk stage II colon cancer by 37%.

ASCO chief medical officer and executive vice president Julie R. Gralow, MD, FACP, FASCO, echoed the emphasis on the relationship between the 2 abstracts.

“Putting these 2 abstracts into perspective, we as physicians need to be essentially prescribing healthy diet and exercise,” Gralow remarked. “The combination of the 2 [is] synergistic.”

Patient Characteristics and Inflammatory Diet Associations

In categorizing patients’ diets, several associations were found regarding patient subgroups more likely to have a diet in the highest inflammatory quintile. Patients in the highest quintile were more likely to be female (64.0%) be Black (15.4%), and have an ECOG status of 1-2 (35.7%).

Those in the highest quintile were also less likely to be White (76.6%) and were younger (58.7 ± 10.8 years old). The mean age of patients enrolled in the study was 60.9 years (standard deviation, 10.5).

Data presented in this presentation was part of a prospective cohort study taken from a trial where 1625 patients were randomly assigned to 3 vs 6 months of adjuvant FOLFOX (folinic acid, fluorouracil, and oxaliplatin), and were additionally randomly assigned to receive adjuvant celecoxib vs placebo for 3 years.

The primary outcome of the study was DFS, and the secondary outcome was OS.

Char SK, Zemla T, Chao M, et al. Association between empirical dietary inflammatory pattern (EDIP) and survival in patients with stage III colon cancer: Findings from CALGB/SWOG 80702 (Alliance). 

. 2025;43(suppl 17):LBA3509. doi:10.1200/JCO.2025.43.17_suppl.LBA3509

Booth CM, Vardy JL, O'Callaghan CJ, et al. A randomized phase III trial of the impact of a structured exercise program on disease–free survival (DFS) in stage 3 or high-risk stage 2 colon cancer: Canadian Cancer Trials Group (CCTG) CO.21 (CHALLENGE). 

. 2025;43(suppl 17):LBA3510. doi:10.1200/JCO.2025.43.17_suppl.LBA3510.

Patients with stage III resected colon cancer had lower risk of death with less inflammatory diets and more regular physical activity.

Anti-Inflammatory Diet/Exercise Promotes OS in Advanced Colon Cancer

The FDA has granted accelerated approval to telisotuzumab vedotin-tllv (Teliso-V; Emrelis) for use in adult patients with locally advanced and metastatic non-squamous, non-small cell lung cancer who have received prior systemic therapy and have high c-Met protein overexpression, according to a news release from AbbVie, the drug’s developer.

The approval is based on data from the phase 2 LUMINOSITY study (NCT03539536). Patients on the trial with high c-Met expression in NSCLC (n = 84) saw a 35% overall response rate (ORR; 95% CI, 24%-46%). The median duration of response (DOR) was 7.2 months (95% CI, 4.2-12).

Telisotuzumab vedotin-tllv has earned accelerated approval for use in patients with non-squamous non-small cell lung cancer with high c-Met overexpression.

Michelle Kirschner, RN, MSN, ACNP, APRN-BC

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