New ONS Practice Guidelines for Chemotherapy and Immunotherapy to Publish in the Fall

Oncology Nursing NewsJune 2018
Volume 12
Issue 5

A foundational volume in oncology nursing gets an upgrade.

Chemotherapy and Biotherapy Guidelines and Recommendations for Practice

With the explosion of immunotherapy and rapid changes in oncology treatment guidelines, it is all nurses can do to stay abreast of best practices. The Oncology Nursing Society (ONS) will soon fill this growing educational gap with a complete update of Chemotherapy and Biotherapy Guidelines and Recommendations for Practice, a classic foundational volume now in its fourth edition. This fall, the ONS will publish the revamped and renamed volume as the first edition of the Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice.

The reorganized book includes a new chapter that focuses on the treatment of cancer using the immune system, immunotherapeutics. The chapter presents 6 categories of this approach: checkpoint inhibitors; chimeric antigen receptor (CAR) T-cell immunotherapy; cytokines; monoclonal antibodies, including radioimmunotherapy; immunomodulators; and oncolytic viral therapy.

Other chapters focus on chemotherapy, molecularly targeted anticancer agents, and hormonal therapy, with updates on unique toxicities such as colitis, pneumonitis, and dermatitis.


Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice contains extensive details related to every toxicity of antineoplastic therapies, with evidence-based approaches for prevention and management. “It is critical that oncology nurses use the most current evidence when managing patients who have cancer,” said MiKaela Olsen MS, APRN-CNS, AOCNS, FAAN, lead editor of the new volume and an oncology and hematology clinical nurse specialist, Ambulatory Oncology, Sidney Kimmel Comprehensive Cancer Center, at Johns Hopkins Hospital and Greenspring Oncology, and lead editor of the new volume.

“These guidelines provide that evidence in a quick, easy-to-follow outline and tablet format. The book is also an excellent resource for nurses working in other fields who may administer these therapies and manage these patients after treatment.”

Important Updates

The first edition of Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice incorporates major new content since the publication of the fourth edition of Chemotherapy and Biotherapy Guidelines and Recommendations for Practice.

  • The new chapter “Immunotherapy” covers all therapies that treat or support cancer using the immune system.
  • Extensive, up-to-date drug tables in each therapeutic chapter—including new content on hormone therapy—help guide nurses during administration.
  • Safety recommendations that align with the ASCO/ONS Chemotherapy Administration Safety Standards are included for the prevention of patient errors.
  • The requirement that nurses use a closed system transfer device during administration of hazardous drugs, consistent with USP General Chapter <800> Hazardous Drugs standards, is discussed.
  • New figures, tables, and algorithms provide easy access to content.

Earlier versions have been used worldwide to guide oncology nursing practice, Olsen said, and the book serves as the foundation for the ONS/ ONCC (Oncology Nursing Certification Corporation) Chemotherapy Biotherapy Certificate Course content. Nurses at any stage of their career can refer to the book as a guide for identifying and learning how to manage adverse effects of cancer and its treatment.


The new volume provides content on professional considerations such as scope and standards, professional education, policies and procedures, antineoplastic medication safety, ethical and legal issues, and patient education. Adhering to national, state, and institutional standards is a fundamental responsibility of all nurses, and each section of the guidelines explains and references standards that oncology nurses should be aware of and follow.

Olsen notes that documentation requirements, safety requirements outlined in the ASCO (American Society of Clinical Oncology)/ONS Chemotherapy Administration Safety Standards, and important standards regarding vascular access devices and intravenous therapy per ONS’ Access Device Standards of Practice for Oncology Nursing are all included.


An overview of cancer treatment plus chapters devoted to the major types showcase the complexity and provide detailed recommendations for approved therapies to guide the oncology nurse during preparation and administration. Safe administration of cancer therapies and a guide to preventing and managing infusion-related reactions (eg, hypersensitivity, cytokine release syndrome, and infiltration and extravasation) are highlighted.

“Keeping the nurse safe during administration of antineoplastics is a top priority for the Oncology Nursing Society,” Olsen said. “The book includes a chapter on handling of hazardous drugs, though oncology nurses should also have the third edition Safe Handling of Hazardous Drugs book, which includes more in-depth information on this topic.”

Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice will be sold in hard copy and as an ebook. The book will be available in fall 2018 directly from the ONS and through most major book retailers, including Amazon.

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