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Hope S. Rugo, MD, FASCO, outlined the top considerations for nurses managing toxicities related to PI3K and AKT inhibitors in patients with breast cancer.

PI3K and AKT Inhibitor Toxicity Advice From a Breast Cancer Expert

Adding sonrotoclax to zanubrutinib led to deep and durable response in relapsed or refractory mantle cell lymphoma, according to EHA Congress data.

Sonrotoclax/Zanubrutinib Generates Durable Response in R/R MCL

2025 ICE-T Conference presenters explain what nurses and APPs should take into account as immune cell effector therapies become more widely used.

Q&A: Nursing Considerations From Immune Cell Effector Therapy Experts

Hope S. Rugo, MD, FASCO, emphasized the importance of educating patients about proactive rash and diarrhea management while taking PI3K/AKT inhibitors.

Proactive Rash Management Vital for PI3K, AKT Inhibition in Breast Cancer

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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 

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Gina Mauro currently serves as Vice President of Content at MJH Life Sciences, overseeing 

®. Gina joined the company in 2015 and has held various positions on 

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

FDA accelerated approval was given to zongertinib for the treatment of patients with unresectable/metastatic nonsquamous NSCLC with HER2 TKD activating mutations.

Zongertinib Nabs FDA Approval in Nonsquamous HER2 TKD+ NSCLC

Stephanie Mompoint is a research APRN at the University of Miami.

Subcutaneous daratumumab offers shorter clinic visits and high tolerability for patients with multiple myeloma, says Stephanie Mompoint, APRN.

Subcutaneous Daratumumab Provides Speedier Multiple Myeloma Treatment

Dalissa Tejera, MSN, APRN, ANP-C, is a nurse practitioner at the University of Miami's Sylvester Comprehensive Cancer Center.

This Rx Road Map outlines the most important information nurses should know when treating patients with astrocytoma or oligodendroglioma with vorasidenib.

Rx Road Map: Vorasidenib for the Treatment of Astrocytoma/Oligodendroglioma

Ronald Bleday, MD, is the section chief of the Division of Colorectal Surgery and vice chair for quality and patient safety in the Department of Surgery at Brigham and Women’s Hospital in Boston, Massachusetts.

Ronald Bleday, MD, explained that a model to reduce opioid use in patients after colorectal surgery relies on nurses familiar with the relevant surgeries.

Oncology Nurse Inclusion Is Crucial to Stepwise Opioid Reduction Model

Oncology Nursing News connects oncology nurses and APPs with updates on therapy advances, side effect management, and patient-centered cancer care.

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 Beth Finley-Oliver, MSN, ARNP, AGNP-BC, a nurse practitioner who works in the outpatient hematology clinic at Moffitt Cancer Center, revisits her presentation from the 2023 JADPRO Live Annual Meeting and discusses the growing number of therapies for patients with relapsed or refractory multiple myeloma.

“A clinical trial upfront would be my first option. After that, I have to try and find something their myeloma hasn't seen yet.”

“With CAR T, the CRS incidence is higher, and I think we're doing better [at managing it] because we have multiple interventions. We see viral infections with [both] the CAR T and the bispecifics. We always have to kind of keep that in the back of our mind.”

“The more medications we have, the more this is turning into a chronic illness.”

Delivering Teclistamab in the Outpatient Setting

Ambulation Improves Frailty Scores in Patients With Multiple Myeloma

With New Bispecific Antibodies in Multiple Myeloma, Nurses Need To Know How to Manage CRS

Managing Teclistamab-Induced CRS for Patients With Multiple Myeloma

Data Supporting Elranatamab Approval in Multiple Myeloma

Data Behind Talquetamab Approval in Multiple Myeloma

Beth Faiman Discusses Recent Changes in Multiple Myeloma Treatment Landscape

ASH Data Offer Treatment Direction for Oncology Nursing Professionals

A Look Back at 2022 FDA Approvals in Oncology

Conversations Around Selinexor: Best Nursing Practices in Multiple Myeloma

Beth Finley-Oliver, MSN, ARNP, AGNP-BC, recaps part of her presentation from the 2023 JADPRO meeting about caring for patients with high-risk multiple myeloma. 

Finley-Oliver Talks Talquetamab and Other Later Line Multiple Myeloma Therapies

In May 2023, the FDA granted accelerated approval to epcoritamab-bysp (Epkinly) for the treatment of adult patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL), including DLBCL arising from indolent lymphoma, and high-grade B-cell lymphoma (HGBL), following 2 or more lines of systemic therapies. Shortly thereafter, in June 2023, the FDA granted accelerated approval to glofitamab-gxbm (Columvi) as a fixed duration treatment for patients with R/R DLBCL not otherwise specified or large B-cell lymphoma (LBCL) arising from follicular lymphoma, after 2 or more lines of systemic therapy.

, Laura Zitella, MS, RN, ACNP-BC, AOCN, who is a hematology nurse practitioner in the Hematology, Blood, Marrow Transplant, and Cellular Therapy (HBC) program at UCSF Health and associate clinical professor in the Department of Physiological Nursing at the University of California San Francisco, joins 

 to discuss how these newly approved bispecific antibodies are expanding third-line treatment options for patients with DLBCL.

“Bispecific antibodies are antibodies that generally have at least 2 antigen binding sites: 1 binding site is to the antigen of interest on the cancer cell, and in lymphoma, that's often CD19, or CD20. The other antigen binding site is to CD3, which is a T-cell marker.”

“Unfortunately, we do not cure all patients with second-line therapy, [and] the bispecifics are used for third-line therapy, where we have historically had limited treatment options.”

“One of the big advantages of bispecific antibodies is that they are ‘off-the-shelf;’ they do not need to be manufactured, and they are available immediately.”

“Epcoratimab is a subcutaneous [administration] bispecific antibody, whereas glofitamab is an intravenous [administration]. Both require step-up dosing, which means that you start with a small dose and then the subsequent doses are a little bit higher, and a little bit higher until you reach your treatment dose.”

Glofitamab Gains Accelerated Approval for Relapsed/Refractory DLBCL

Epcoritamab Obtains Accelerated Approval for Relapsed/Refractory DLBCL

Investigators Unveil Real-World Experiences on Shared Decision-Making in R/R DLBCL

With New Bispecific Antibodies in Multiple Myeloma, Nurses Need to Know How to Manage CRS

Novel Immune Checkpoint Inhibitors, Bispecific Antibodies Become Clinical Mainstays in Melanoma Nursing

Smith Discusses Evolving Landscape of Lymphoma Treatments

Bispecific Antibodies May Change Lung Cancer Paradigm

Oncology Nursing Stories: Off-The-Shelf CAR T Therapy for Acute Lymphoblastic Leukemia

Oncology Nursing Stories: Pregnancy After Lymphoma Chemoradiation

Stephanie Jackson Unpacks Recent Advances in Leukemia Treatments

Laura Zitella, MS, RN, ACNP-BC, AOCN, discusses how newly approved bispecific antibodies are expanding third-line treatment options for patients with diffuse large B-cell lymphoma. 

Laura Zitella Discusses the Growing Arsenal of Bispecific Antibodies in DLBCL

, Beth Faiman, PhD, CNP, weighs in on the current trajectory of research and clinical practice in multiple myeloma.

Faiman is a nurse practitioner and researcher with the Cleveland Clinic, as well as a board member of the NP/PA Center of Excellence in Multiple Myeloma. According to her, one of the biggest changes of late was the publication of a study in 

, findings of which suggest that patients with biomarker-defined defined disease, as well as 60% or more bone marrow plasma cells (BMPCs), or a free light chain ratio (FLCratio) of at least 10, have a longer time to progression and a lower 2-year progression risk than was previously believed.

Whereas the median time to progression was previously reported to be 9.2 months, the new study found the median time to be 30.1 months. Moreover the 2-year progression risk was 45.45%, rather than the previously reported 85.21%.

As Faiman points out, in 2014, the International Myeloma Working Group had added patients with at least 60% BMPCs, FLCratio equal to or greater than 100, and greater than 1 MRI-defined focal lesion of at least 5 mm (SLiM CRAB multiple myeloma) to the diagnostic category of multiple myeloma. However, this newer review suggests that this classification may need to be revisited.

Faiman also touches on shifts in approved BCMA-directed therapies for patients, namely, the accelerated approval of teclistamab-cqyv (Tecvayli) in October of 2022, and the removal of belantamab mafodotin-blmf (Blenrep) from the market in November 2022.

 She notes that there are ongoing efforts to reincorporate belantamab mafodotin into clinical practice and that she is optimistic about reintroducing this treatment back into her practice—as the dosing schedule and toxicity profile was favorable for patients. 

“Supporting [a] patient while they are in their maintenance phase [of treatment]; checking the blood counts, keeping up [with] health maintenance, making sure their bones are strong and all those other supportive care things, are so important.”

“If you have a heavily pretreated patient on some of the new cellular therapies or bispecifics, that they have to be admitted to the hospital, we have to logistically manage who’s going to be admitted on what day and when.”

“The nice thing about belantamab was that it was an [intravenous] IV [therapy] every 3 weeks, it is directed against BCMA, and it was very well tolerated.”

Hematologic Oncology Undergoes Transformation With Drug Updates and Approvals

Teclistamab-cqyv Snags Accelerated Approval for Relapsed or Refractory Multiple Myeloma

Belantamab Mafodotin Will No Longer Be Available For Multiple Myeloma

Ocular Visits Are a Necessity for Patients With Multiple Myeloma Who Receive Belantamab Mafodotin

Ludwig H, Kainz S, Schreder M, Zojer N, Hinke A. SLiM CRAB criteria revisited: temporal trends in prognosis of patients with smoldering multiple myeloma who meet the definition of ‘biomarker-defined early multiple myeloma’-a systematic review with meta-analysis. 

. 2023;58:101910. doi:10.1016/j.eclinm.2023.101910

FDA approves teclistamab-cqyv for relapsed or refractory multiple myeloma. FDA. October 25, 2022. Accessed April 10, 2023. 

GSK provides an update on Blenrep (belantamab mafodotin-blmf) US marketing authorization. News release. GlaxoSmithKline. November 22, 2022. Accessed April 10, 2023. 

Beth Faiman, PhD, CNP, discusses reclassifying patients with multiple myeloma, the accelerated approval of teclistamab, and the removal of belantamab mafodotin from the US market. 

It takes a special skillset for nurses to care for patients whose disease continues to relapse after multiple lines of therapy, shares Stephanie Jackson, DNP, MSN, RN, AOCNS, BMTCN.

“I tell my younger staff who aren’t used to seeing patients this sick, ‘even if that patient doesn’t survive, what an honor for us to be a part of their journey,’” she tells 

, Jackson, an oncology and bone marrow transplant clinical nurse specialist and unit director at UCLA Medical Center, recalls the story of a patient with acute lymphoblastic leukemia (ALL) who relapsed following treatment with induction chemotherapy and whose disease did not respond to blinatumomab (Blincyto). The team chose to give this patient an off-the-shelf CD22-directed CAR T-cell therapy—which was successful, until the patient ultimately relapsed 6 weeks later.

Jackson emphasizes how, in addition to his physical symptoms, this patient was burdened by worry for his family. As the primary breadwinner in a family with a 2-year-old daughter, he was stressed about how to continue caring for his family. Moreover, he grappled with a language barrier prevented the patient from understanding the complexity of the treatments that the team was prescribing for him. Therefore, Jacksons’ team had to find innovative ways to ensure that the patient, and his family, felt well supported throughout his treatment.

“The biggest challenge we had was [ensuring] his understanding of how sick he really was, the complexity of the treatment, and that he wouldn’t be able to go back to work right away,” she says.

[The patient] presented with bone pain [and] was experiencing chronic fatigue, excruciating acute bone pain in his lower extremities, and low-grade fevers, which caused him to go into his hospital in his area. Fast forward, he had a bone marrow biopsy done [and] they diagnosed him with Philadelphia chromosome–negative ALL. 

Given that it’s a clinical trial [product], we don’t always know [what to expect]. We know with the FDA approved products, the 2 biggest factors we need to monitor patients for is cytokine release syndrome and neurotoxicity. These were the things we were watching for. 

We did a lot of work with our social worker, he was Mixteca Alto, an indigenous population within the Mexican community, and we wanted to make sure we had the appropriate interpreters. 

Oncology Nursing Stories: Acupuncture Helps Thyroid Cancer Survivor Taper Opioid Use

Blinatumomab Plus Consolidation Chemotherapy Significantly Reduces Risk of Death in MRD-Negative B-Cell ALL

FDA Approves Blinatumomab for Patients with Acute Lymphoblastic Leukemia and Minimal Residual Disease

The Shifting Dynamics of Social Support After a Cancer Diagnosis

Verina on Tackling Neurological Toxicities From CAR T-Cell Therapy

Expert Weighs in on Future of CAR T-Cell Therapy Treatment Directions

Preparing Patients for CAR T-Cell Therapy With Confidence

The Future of CAR T-Cell Therapy: Will Off-the-Shelf Options Soon Enter the Playing Field?

Navigator Offers Strategies to Support Non-English Speaking Patients

Stock W, Luger SM, Advani AS, et al. A pediatric regimen for older adolescents and young adults with acute lymphoblastic leukemia: results of CALGB 10403. 

. 2019;133(14):1548-1559. doi:10.1182/blood-2018-10-881961

Phase 1/2 study of UCART22 in patients with relapsed or refractory CD22+ B-cell acute lymphoblastic leukemia (BALLI-01). ClinicalTrials.gov. Updated September 27, 2022. Accessed March 3, 2023. 

https://clinicaltrials.gov/ct2/show/NCT04150497

In this episode of The Vitals, Stephanie Jackson, DNP, MSN, RN, AOCNS, BMTCN, discusses the treatment journey of a patient who required multiple lines of therapy for ALL.

Oncology Nursing Stories: Off-The-Shelf CAR T Therapy for Acute Lymphoblastic Leukemia 

, Nilesh Kalariya, PhD, AGPCNP-BC, AOCNP; and Laura J. Zitella, MS, RN, ACNP-BC, AOCN, discuss data from the 64th American Society of Hematology Annual Meeting and Exposition that have the greatest potential to change oncology nursing practice.

Kalariya, a nurse practitioner with the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, recently spoke with 

highlighted research from the University of Pennsylvania which showed clinical utility of a frailty phenotype tool and contextualized the role of CAR T-cell therapy for patients with multiple myeloma. He also discussed whether data from a subgroup analysis of patients with multiple myeloma who received the anti-BCMA CAR T-cell therapy in the KarMMa-2 trial (NCT03601078) supports moving it forward in the treatment lineup.

Zitella, a nurse practitioner in the Department of Hematology, Blood & Marrow Transplant, and Cellular Therapies Program at the UCSF Helen Diller Family Comprehensive Cancer Center and an associate clinical professor with the School of Nursing University of California, San Francisco, also spoke with 

, highlighting exciting advances with BTK inhibitors and how nurses can promote safe eating habits after data from ASH demonstrated that the neutropenic diet does not benefit patients. on which data from the 2022 ASH meeting might have the greatest impact on nurses working in hematologic oncology.

Interested in learning more from ASH? Check out our coverage of the 

We want to hear from you! Which ASH data do you think will be practice-changing? Email 

“This study that came out at ASH in a transplant population, which is the most immunocompromised population really highlights the [neutropenic diet] and brings it front and center. Hopefully, this will be enough to convince people to abandon the neutropenic diet.” 

“What we see here is that CAR T-cell therapy, followed by maintenance therapy might be a key in frontline settings to have a longer duration of response.” 

“For relapsed or refractory chronic lymphocytic leukemia, zanubrutinib [Brukinsa] had a better overall response rate and progression-free survival than ibrutinib [Imbruvica].” 

FDA Grants Pirtobrutinib Accelerated Approval for Relapsed/Refractory MCL

Noncovalent BTK Inhibitors May Fill Unmet Needs in CLL and Other Top ASH Takeaways

Nilesh Kalariya, PhD, AGPCNP-BC, AOCNP; and Laura J. Zitella, MS, RN, ACNP-BC, AOCN, discuss practice-changing presentations from the 64th American Society of Hematology Annual Meeting and Exposition.

Hematology

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