Oncology Nursing News Top Stories: January 2023

Each month, Oncology Nursing News® takes a look back at our most popular stories. In January 2023, data presented at the 2022 San Antonio Breast Cancer Symposium continued to grab the attention of oncology nurses. Below, find links to poster presentations highlighting new innovations in tamoxifen-related symptom management, and an exclusive interview highlighting key nursing takeaways of interest from the meeting. Moreover, read up on the FDA’s approval of elacestrant (Orserdu), which followed updated data presented at the meeting.

Other topics of interest included pain management, a core component of cancer care. However, use of agents to curb these effects, especially opioids, present challenges in practice. Fortunately, the American Society of Clinical Oncology (ASCO) has recently updated their opioid management guideline, providing clearer instruction on best practices with these critical pain management drugs.

Lastly, January is cervical cancer awareness month. Oncology Nursing News® published a 4-part weekly series on what oncology nurses need to know to best advocate for their patients with cervical cancer, which included updates in prevention and treatment options.

5. CBD Oil Shows Modest Improvements in Tamoxifen-Related Adverse Effects

A poster presentation from the 2022 San Antonio Breast Cancer Symposium demonstrated that cannabidiol (CBD) oil may be useful in managing tamoxifen-related adverse effect (AEs).

In a study population of 26 patients, the oil was associated with decreases across several AEs related to tamoxifen, including insomnia, hot flashes, arthralgia, mood alterations, and muscle cramps. In addition, median health-related quality-of-life scores increased after 4 weeks with CBD, and the treatment may have demonstrated improvements in endocrine symptoms as well.

Of note, study authors acknowledged that the study period was short and that longer study periods may reveal better insight on whether CBD may provide long-lasting improvements in these domains.

4. Emerging Data Showcases Promising Advancements for Patients With HER2-Low Breast Cancer

In an interview with Oncology Nursing News®, Loyda Braithwaite, MSN, RN, AGPCNP-BC, AOCNP, highlighted promising advances in breast cancer treatments across multiple settings and disease types, including for patients with HER2-low and hormone receptor–positive disease.

In the conversation, Braithwaite, who is an oncology nurse practitioner at the University of Wisconsin Carbone Cancer Center, discussed fam-trastuzumab deruxtecan-nxki’s (Enhertu) performance across the DESTINY-Breast02 (NCT03523585), DESTINY-Breast03 (NCT03529110) and TRIO-US B-12 TALENT trial (NCT04553770) trials, as well as sacituzumab govitecan-hziy’s (Trodelvy) expanding use in the hormone receptor–positive setting in TROPiCS-02 (NCT03901339).

She also discussed whether oral SERDs hold the potential to change practice. “[Oral SERDs] are very exciting from the clinician perspective, but also from the patient perspective, to think about the accessibility [options] that we’re going to have to treat them,” she told Oncology Nursing News®.

3. ASCO Guidelines Provide Road Map for Cancer Pain Management With Opioids

Unfortunately, 55% of patients experience pain during active treatments, and 66% of patients with advanced disease will experience cancer-related pain. Although guidelines for managing cancer-related pain exist, there are few guidelines focused on exclusively on opioids.

ASCO has updated its guidelines providing recommendations for the management of cancer pain with opioids. A multidisciplinary expert panel consisting of patient representatives and an ASCO guidelines staff member with health research methodology expertise developed the guidelines that were informed by evidence including 16 randomized controlled trials and 31 systemic reviews from January 1, 2010, to February 17, 2022.

The supportive care guidelines addressed 7 key questions for patients with cancer pain under all of which fell under the umbrella of the leading question: “In what circumstances should opioids be used to manage cancer pain in adults, how should opioids be administered, and how should opioid AEs be prevented or managed?”

2. FDA Approves Oral SERD Elacestrant for ESR1-Mutant ER+, HER2– Metastatic Breast Cancer

On January 27, 2023, the FDA granted an accelerated approval to elacestrant (Orserdu) for the treatment of patients with ESR1-mutant,estrogen receptor–positive, HER2-negative advanced or metastatic breast cancer following at least 1 prior lines of endocrine therapy. The approval is supported by data from the phase 3 EMERALD study (NCT03778931).

The investigational oral selective estrogen receptor degrader (SERD) was evaluated among patients with ESR1-mutant disease (n = 115) vs standard-of-care (SOC) endocrine therapy (n = 113) of either fulvestrant or an aromatase inhibitor. The median progression-free survival was 3.8 months (95% CI, 2.2-7.3) vs 1.9 months (95% CI, 1.9-2.1) with the SERD and SOC, respectively (HR, 0.55; 95% CI, 0.39-0.77; P = .0005).The overall survival outcomes were not statically significant (HR, 0.90; 95% CI, 0.63-1.30).

1. Cervical Cancer Prevention Comes Into Focus for Awareness Month

January is cervical cancer awareness month. In this first installment of a weekly series on the oncology nurse’s role in patient advocacy efforts, Debi Fischer, MSW, BSN, BA, LCSW, RN, highlights current educational efforts of disease progression and the Quilt Project.

In 2022, there were 4280 deaths caused by cervical cancer. The FDA has given the greenlight to 3 human papillomavirus (HPV) vaccines: Gardasil, Gardasil 9, and Cervarix. These vaccines are believed to be able to prevent 90% of HPV-attributable cancers. Moreover, Papanicolaou tests is a highly effective screening tool which can help providers combat cervical cancer before it even occurs. If a woman follows screening recommendations, cervical cancer can be found before it becomes invasive and spread. Treatment options are more extensive at this level and in fact precancerous cell changes can also be discovered.

According to Fischer, the advances that have been made in cervical cancer have been significant. Oncology nurses play a significant role about raising awareness, and ensuring that these advances have the opportunity to positively affect their patients.