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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

Paolo Tarantino, MD, PhD, explains that the chemotherapy-related toxicities from an ADC are more likely to limit dosage for patients with cancer.

Understanding How On-Target and Off-Target ADC Toxicities Work

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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 

Survivorship expert Michelle Kirschner, MSN, RN, ACNP, APRN-BC, says that “doable changes” can enhance the lives of patients surviving cancer.

Diet, Exercise Help Patients “Flourish” In Cancer Survivorship

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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

New FDA approvals in July include therapies for NSCLC, relapsed multiple myeloma, liver cancer, and B-cell malignancies.

July FDA Oncology Approvals Include Options for NSCLC, Myeloma, and More

Adding aprepitant to chemotherapy was linked to longer survival in patients with non-luminal breast cancers, especially triple-negative breast cancer.

Adding Aprepitant to Chemo Extends Non-Luminal Breast Cancer Survival 

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.

Experienced oncology nurses and APPs can help nurses newer to the field understand who is more at risk of opioid addiction, says expert Ronald Bleday, MD.

Nurse-Peer Mentorship Can Help Prevent Opioid Addiction in Post-Op CRC

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

, 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. 

Step-up dosing with remote monitoring resulted in 47% of patients receiving bispecific antibodies remaining outpatient, even in cases of CRS.

SUD, Remote Monitoring Appear Feasible for Outpatient BiTE in MM

The FDA has given accelerated approval to the BiTE, linvoseltamab, for use in the fifth line of therapy for relapsed/refractory multiple myeloma.

Linvoseltamab Gains FDA Accelerated Approval In R/R Myeloma

The FDA removed REMS and reduced certain monitoring needs for liso-cel and ide-cel in B-cell malignancies.

FDA Relaxes REMS, Monitoring Rules for Liso-Cel and Ide-Cel

Heather Wenberg, a regional nursing director for American Oncology Network, discusses the benefit of subcutaneous vs IV daratumumab.

Subcutaneous daratumumab requires less chair time and premedication for patients with multiple myeloma

The subcutaneous formulation of daratumumab with hyaluronidase-fihj (Darzalex Faspro) allows patients with multiple myeloma to spend less time receiving treatment and requires fewer premedications than the intravenous (IV) formulation of daratumumab (Darzalex), according to Heather Wenberg, BSN, RN, OCN.

Wenberg, a regional director of nursing at the American Oncology Network, explained in an interview with 

, patients with myeloma receive premedication and observation for the first cycle of treatment but can for the most part forgo premedication and observation following that cycle.

She emphasized that patients receiving IV daratumumab usually receive premedication at each cycle and spend more time in the infusion chair. Meanwhile, Wenberg shared that patients receiving subcutaneous daratumumab can be in and out of clinic within an hour or less.

As far as decreasing chair time, if patients were getting the IV version [of daratumumab], they would have an IV in their arm, [receiving] premeds all the time, and they would have a 3-hour infusion each time. By having the 

, they get their labs, then they are clear. We do our double checks, they get their injection. Patients can be in and out of the clinic within 1 

Subcutaneous administration is our formulary for American Oncology Network, so that’s our go-to for all of our patients. For patients receiving IV daratumumab, we would educate them on premeds, how the premeds would be each time, and the length of time it takes for that infusion, vs for patients receiving subcutaneous daratumumab, we educate them on the premeds for the first cycle, and then the ease of being able to get in and out with their shot on a weekly basis.

With the first cycle, we like to be very cautious, because we do not want the patient to have anaphylaxis or any other type of issue. They usually get 50 mg of IV Benadryl, 20 mg of IV dexamethasone, and oral [acetaminophen]. We wait about 60 minutes after administration, and then we start the subcutaneous injection.

In the first cycle, we monitor them for about 2 hours after. Once they’re doing fine, we omit that observation. Occasionally if it’s indicated, providers will order a post-injection dose of methylprednisolone (Solu-Medrol), but that’s not the case with all the patients. Most patients do very well with it, and they like the subcutaneous administration of daratumumab.

This transcript has been edited for clarity and conciseness.

Patients receiving subcutaneous daratumumab have less chair time and premedication than those receiving IV formulation, says Heather Wenberg, BSN, RN, OCN.

Subcutaneous Daratumumab Requires Less Time, Premed in Multiple Myeloma

Ongoing discussions within the myeloma community reflect the need for clearer sequencing pathways, particularly regarding the role of CAR T-cell therapy vs bispecifics and chemo.

CAR T-cell therapy is gaining ground earlier in treatment, with some clinics discussing its use even before transplant in eligible patients.

The conversation around sequencing for multiple myeloma is still a work in progress, according to bone marrow transplant specialist Nick Barkemeyer, PA-C, MMS, of the Centennial Center for Blood Cancers Clinic in Nashville, Tennessee. However, CAR T-cell therapies are emerging sooner as confidence around their use grows among providers.

In an interview following a Community Case Forum with 

, Barkemeyer, who moderated the discussion with his peer oncology advanced practice providers, emphasized that CAR T-cell therapy provides a strong and effective option for multiple myeloma following bone marrow transplant.

While patients and providers alike may harbor hesitation, whether due to unfamiliarity with the treatment type or worries that it may be too strong to start with compared with more traditional cancer treatment options, CAR T-cell therapy is becoming a more immediate line of therapy in many cases.

As Barkemeyer pointed out, variation in sequencing may also have to do with the type of clinic at which patients are treated. For instance, providers at specialized clinics such as the one where Barkemeyer works, are more likely to have experience with CAR T-cell therapies and may be more likely to recommend it for a patient than providers who work at a community clinic.

We’re bringing [CAR T-cell therapy] into the conversation much earlier now than we used to, especially with the 

; Carvykti]. We’re already sprinkling those thoughts in, even probably before we do transplant. We say, “We’re going to go through transplant, we’re going to do our maintenance after the fact, and then hopefully we can get a nice, long response with transplant. But just know that this is probably our next option going forward here, if and when relapse does occur.”

We [at the Centennial Center for Blood Cancers Clinic] are starting to implement [CAR T-cell therapies] much sooner, being the type of facility that is heavily involved in the research, and we’re the 

. We’re doing these conversations much sooner, compared with some places where they may be a little bit less familiar with it, and they might still believe, “Oh, this is something that we can use later on down the road.”

I even mentioned this in the program. Some of your savvier patients will make an argument such as, “I want to do all my traditional options first before I consider an immunotherapy like CAR T-cell therapy because that seems like it’s a really good option, but I don’t want to use it up too soon.”

The community really hasn’t gotten a firm grasp on what the 

 is with everything. We still like to opt for transplant first. But then once that occurs, it’s like, “What do we do next? Do we do traditional [chemotherapy] and then do CAR T-cell therapy? Do we go right into CAR T-cell therapy? Do we try to do everything else, like a bispecific, before we do a CAR T-cell therapy? Do we do bispecifics after CAR T-cell therapy?” It’s still being discussed and talked about in the multiple myeloma community.

CAR T-cell therapy is starting to enter treatment conversations sooner with patients with multiple myeloma, according to Nick Barkemeyer, PA-C, MMS.

CAR T-Cell Therapy May Be Moving Up in Myeloma Treatment Sequencing

A research APRN describes how educating patients can help them feel more at ease and better prepared to prevent adverse events.

Education Reassures Patients With Multiple Myeloma Receiving Subcutaneous Daratumumab

Although subcutaneous daratumumab with hyaluronidase-fihj (Darzalex Faspro) is considered widely tolerable and reduces chair time for patients being treated for multiple myeloma, oncology nurses should be aware when administering the injection that patients may be intimidated by the needle size and may need some reassurance, according to Stephanie Mompoint, APRN, a research advanced practice nurse at the University of Miami.

Mompoint recommends talking through what to expect with patients, from the injection volume to potential adverse events (AEs). As Mompoint emphasized, subcutaneous daratumumab can cause a rash at the injection site, and while systemic reactions are not always expected of subcutaneous injections, they are still possible.

She advises nurses to watch for signs of systemic reactions such as chills during and after administration of daratumumab. When educating patients on AEs, nurses should encourage patients to report persistent redness that spreads so that they can receive topical treatment to reduce irritation.

Daratumumab has been approved as a monoclonal antibody drug treatment of multiple myeloma. It’s given as 1 infusion, together with daratumumab and hyaluronidase.

You’re going to have that reaction from the patient seeing the needle when they see the volume that’s going to be inserted. It’s [essential to] reassure them and let them know that the premedications will help with reaction, and, as the nurse, to be alert for possible immediate systemic reactions.

Now, just because the drug is given subcutaneously, that doesn’t mean that the systemic reactions are not going to happen, like fevers [and] chills. It’s important to talk to the patient, and you be on the lookout for that. If your patient starts to have chills, even while you’re doing the subcutaneous injection, you have to stop the injection and give the patient time to settle down, take their temperature, do their vitals, and call the provider if extra medication is needed.

I’ve gotten questions about that, and it’s important, because imagine that the patient’s going to start a new therapy, and they know it’s subcutaneous, but a lot of time you don’t think about the quantity of some subcutaneous [injections] that’s going to be administered. The more the patient knows, the more at ease they will be, and the more alert they will be, also. Then they know what to look out for.

One simple thing [to do] is let them know, “Yes, you’re going to start with a needle stick. And it might sting at the beginning.” And then as we’re pushing more and we’re having conversation, educating them that the site might be a little bit swollen, and when you go home, you might find a rash there.

“Now it’s OK to have some redness, but if that redness continues to spread, you need to let us know, because something as simple as some topical steroid could help with that.” It goes back to education, to letting them know and reassuring them, and explaining things in a way that they will understand.

Education before subcutaneous daratumumab administration can both reassure patients and reduce the occurrence of adverse events, according to Stephanie Mompoint, APRN.

Education Reassures Patients With MM Receiving Subcutaneous Daratumumab

Yi Lin, MD, PhD, explains that nurses and APPs can prevent Parkinson's disease following cilta-cel by monitoring lymphocite counts and side effects in multiple myeloma

Yi Lin, MD, PhD, discusses ways nurses and APPs can prevent Parkinson's disease in multiple myeloma

Oncology nurses and advanced practice providers (APPs) can play an active role in preventing long-term and potentially debilitating adverse events (AEs) associated with the treatment of multiple myeloma with ciltacabtagene autoleucel (cilta-cel; Carvykti), says expert Yi Lin, MD, PhD.

2025 American Society of Clinical Oncology Annual Meeting

 regarding her research presented at the conference on identifying risk factors for delayed toxicity in patients receiving 

According to Lin, peak absolute lymphocyte count (ALC) greater than 3 x 10

By monitoring patients’ CBC and other symptoms, nurses and advanced practice providers can spot early indicators of parkinsonism risk, per Yi Lin, MD, PhD.

Multiple Myeloma

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