In 2020, the FDA approved more than 50 new cancer treatment regimens, bringing 19 new drugs to the market. While the majority of those drugs are given orally, there were also subcutaneous or intravenous therapies that were approved, too.
It is crucial that oncology nurses keep up with these new developments in the oncology space and know what kind of adverse events to look out for, according to R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA.
Harvey recently gave a pharmacology update at the 38th Annual CFS Virtual, Interactive Meeting.
Harvey discussed belantamab mafodotin (Blenrep), an antibody drug conjugate that was approved for patients with multiple myeloma who had 4 or more prior lines of therapy and a autologous transplant.
The FDA approved the drug at the 2.5 mg/kg dose after trials showed that amount was noninferior to a higher 3.4 mg/kg dose.
While many patients on the trial reported little or no symptoms, many of them experienced vision changes, such as blurred vision or loss of acuity, when seen by an ophthalmologist, as the trial mandated. Therefore, oncology nurses should discuss potential issues with sight for patients who are on this treatment.
“The overall response rate was about 31%,” Harvey said. “But the big issue, I think, that’s really valuable with this agent is that in those people who did respond, it was quite durable. So even if patients had to stop the drug, if they had a response, their durability was maintained for more than 6 months and over in almost three-quarters of people.”
Tafasitamab-cxix (Monjuvi), an anti—CD-19 monoclonal antibody, was approved for the treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).
The drug, which is usually given in combination with lenalidomide (Revlimid) is given with more frequent dosing upfront, and then frequency slows down as treatment progresses.
“And what's happening is you're really clearing out the disease by giving these doses quickly in a relatively short period of time,” Harvey explained.
When administering tafasitamab-cxix, nurses need to look out for cytopenia, neutropenia, and diarrhea. “Patients have to be monitored carefully for [blood] counts, ideally weekly, if not early on, and then can be perhaps spread out as patients tolerate therapy,” Harvey said.
Patients with metastatic small cell lung cancer who did not respond to chemotherapy gained a new second-line treatment option this year with the FDA approval of lurbinectedin (Zepzelca).
While the drug proved to be efficacious, more than 20% of patients reported constipation and diarrhea. The agent is also highly emetogenic.
“Patients [experienced] nausea and vomiting prophylaxis, and there certainly can be myelosuppression, which you would expect with alkylating agents,” Harvey said, emphasizing that there is a possibility for liver toxicities, so nurses should monitor patients for that as well.
Finally, Harvey discussed sacituzumab govitecan (Trodelvy), which was approved for the treatment of patients with metastatic triple-negative breast cancer (TNBC).
This antibody drug conjugate targets the Trop-2 protein, which is commonly overexpressed in patients with TNBC.
Clinicians should look out for vomiting, infusion reactions, cytopenia, fatigue, hair loss, abdominal pain, and appetite loss in patients taking this agent.
“Like many of the other drugs I’ve mentioned today, it’s going to be evaluated in earlier stage disease and in different combinations, depending on other therapies,” Harvey said
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