Genetics

Precision medicine is a term that has been in our oncology language for years, but changes are occurring quickly. As oncology nurses, we need to learn about genomics and biomarkers and what precision medicine means for patients’ outcomes.

Kristin Daly, MSN, ANP-BC, AOCNP, discusses pathogenic variant testing and what it means for oncology nurses.

Patients with breast cancer who carry BRCA1, BRCA2, CHEK2, or PALB2 germline pathogenic variants may be at a greater risk for contralateral breast cancer and may benefit from enhanced surveillance and risk-reduction strategies.

Both the gastric and breast cancer HER2 scoring algorithms may be useful in determining which patients with metastatic colorectal cancer may derive benefit with tucatinib/ trastuzumab.

A quality improvement project improved the time to molecular testing for patients with newly diagnosed, metastatic non–small cell lung cancer.

Derazantinib, an FGFR inhibitor, was associated with a median progression-free survival (PFS) of 7.8 months in patients with FGFR2-positive intrahepatic cholangiocarcinoma.

The median radiographic progression-free survival (rPFS) was 11.2 months among patients with castration-resistant prostate cancer who received rucaparib. In the control arm, median rPFS was 6.4 months.

Kristin Daly, MSN, ANP-BC, AOCNP, discusses the clinical significance of tumor variants and how they are changing the direction of cancer care.

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.

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.

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.

At the 6th Annual SONO meeting, Beth Sandy, MSN, CRNP, reviewed available treatment options for patients with identified driver mutations in non–small cell lung cancer.

Paula Anastasia, RN, MN, AOCN, discusses the value of germline testing and the role of maintenance PARP inhibitor therapy in optimized ovarian cancer treatment.

Beth Sandy, MSN, CRNP, discusses some of the challenges that may be associated with molecular testing, and how oncology nurses can help play a role in ensuring that the reports are received.

In early-stage cancers, ctDNA has a role in screening, neoadjuvant monitoring, identification of molecular residual disease (MRD), molecular relapse monitoring, and early assessment of treatment response.

Patients with 4-1BB or LAG-3–expressing T cells at baseline, or a high proportion of PD-L1–expressing myeloid cells and plasmacytoid dendritic cells during boost cycles, may be more likely to benefit from the combination of nivolumab and ipilimumab.

The FDA have granted an accelerated approval to acimibinib, which treats CML by binding to the ABL myristoyl pocket.

Standard guidelines that determine who should undergo genetic testing may result in some cases falling through the cracks, according to recent research.

It is imperative that patients diagnosed with blood cancer undergo the proper molecular testing, one expert says.

With the emergence of several targeted treatments that have shown efficacy in individuals with germline pathogenic variants, specifically in DNA mismatch repair, the need for germline genetic testing has become even more pronounced.

Nurses play a key role in ensuring that patients with gynecologic cancer understand the results and implications of genetic testing.

The FDA has approved Guardant360® CDx for comprehensive genomic profiling in patients with any solid malignant cancer.

Genetic testing is more important now than ever before, as biomarker-driven cancer treatments continue to receive approval across many tumor types. While these personalized treatments are improving outcomes, navigating the landscape of genetic testing can leave patients with questions for their providers.

Given the recent use of genes to determine prognosis and treatment decisions in the field of hematology, it is important for providers to collaborate with geneticists.

Getting an accurate family history can be one of the most challenging things that nurses face, according to Suzanne Mahon, DNSc, a clinical nurse specialist at SLUCare physician group, St Louis, Missouri.

As genetics in cancer care grows, so will the role of the oncology nurse.

A recent survey highlights the multiple barriers to molecular testing in lung cancer, and solutions to overcome them.