Review Article

The Effect of Music Therapy as an Adjunctive Treatment in Pediatric Cancer Patients Receiving Traditional Therapies: A Systematic Review

Debra M. Cole, EdD, PA-C, DFAAPA, Kaitlin Beane, PA-S, Madeleine Engel, PA-S, et al.

Aim: This study aimed to analyze articles that discussed the effect of music as adjunctive therapy to traditional treatments of pediatric cancer patients compared to a control of no music therapy. Background: Cancer is a leading cause of...

Risk Factors for Immune Checkpoint Inhibitor–Related Myocarditis: An Integrative Review

Sara M. Otto, MS, APRN, FNP-BC, AOCNP®, Ashely L. Martinez, DNP, APRN, FNP-BC, AOCNP®, CBCN, CPHQ, NEA-BC, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP, FAAN

Purpose: The purpose of this integrative literature review was to determine factors that increase the risk of immune checkpoint inhibitor (ICI)–related myocarditis in the cancer patient population. Methods: A literature review was conduc...

Does Use of Intratumoral Injections in Solid Tumor Malignancies Improve Outcomes and Reduce Adverse Events? An Integrative Review

Maggie Matyola, APRN, FNP-C, Ashley Martinez, DNP, APRN, FNP-BC, Joyce Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP, FAAN

The purpose of this review is to assess the efficacy and adverse events associated with intratumoral injection in the treatment of solid tumor malignancies. A literature review was conducted using PubMed, the Cochrane Database of Systema...

Impact of Fasting on Patients With Cancer: An Integrative Review

Samantha Thompson, MPH, MCHS, PA-C, Lydia T. Madsen, PhD, RN, AOCNS®, FNAP, and Angela Bazzell, DNP, APRN, FNP-BC, AOCNP®

Background: Patients with cancer often pursue nutrition as an avenue to positively impact their care management and disease outcomes. Nutritional interventions are increasing in popularity, especially intermittent fasting as an adjunct t...

Role of Preemptive Cytomegalovirus Hyperimmunoglobulin in Cytomegalovirus Viremia Following Stem Cell Transplant: An Integrative Review

Jaci Whittaker, MSN, APRN, FNP-BC, Ashley Martinez, DNP, APRN, FNP-BC, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FANP, FAANP, FAAN

Introduction: Cytomegalovirus (CMV) is a major cause of morbidity and mortality in stem cell transplant (SCT) patients. Cytomegalovirus hyperimmunoglobulin (CMV-HIG) therapy has been described in the solid organ transplant setting. Howev...

Advanced Practitioners as Agents of Change: Leveraging Quality Improvement to Improve Practice

Sandra Kurtin,(1) PhD, ANP-BC, AOCN®, FAPO, Andrea Edwards,(2) PA-C, 
Heather Koniarczyk,(3) MSN, APRN-CNP, AOCNP®, Camille Petraitis,(4) DNP, FNP-BC, 
Lisa Nodzon,(5) PhD, APRN, AOCNP®, Nicole Deline,(6) MSN, APRN, FNP-C, AOCNP®, 
Tajuana Bradley,(7) FNP-BC, Megan May,(8) PharmD, BCOP, FAPO, FHOPA, 
Molly Thompson-Coffey,(9) Jessica Tamasi,(9) and Wendy Vogel,(10) MSN, FNP, AOCNP®, FAPO

Scientific innovation in hematology and oncology is constant and increasingly complex, requiring individual clinicians and institutions to effectively integrate standards of care across the diverse hematology and oncology landscape into ...

Role of the Advanced Practitioner in Clinical Research

Christa Marie Braun-Inglis,(1) DNP, APRN, FNP-BC, AOCNP®, Brianna Hoffner,(2) MSN, ANP-BC, AOCNP®, FAPO, Lisa Kottschade,(3) APRN, MSN, CNP, FAPO, 
Erin Pierce,(4) MSN, APRN, FNP-C, and Sandra Kurtin,(5) PhD, ANP-BC, AOCN®, FAPO

Advanced practitioners are key members of the oncology care team, and their numbers and significance continue to expand. While the role of the AP has become well defined in everyday clinical practice, there is still space to define the A...

APSHO Oncology/Hematology Advanced Practitioner Compensation Survey

Wendy Vogel,(1) MSN, FNP, AOCNP®, FAPO, Yi Lisa Hwa,(2) APRN, DNP, CNP, FAPO, Lisa Kottschade,(2) APRN, MSN, CNP, FAPO, and Megan May,(3) PharmD, BCOP, FAPO, FHOPA

The Advanced Practitioner Society for Hematology and Oncology (APSHO) launched its first oncology and hematology advanced practitioner (AP) compensation survey in 2022. This 74-question survey surveyed nurse practitioners, pharmacists, p...

Understanding Advanced Practitioner Prescriptive Privileges for Anticancer Therapies: A National Survey

Archana Ajmera,(1) MSN, ANP-BC, AOCNP®, Leigh Boehmer,(2) PharmD, BCOP, 
Christa Marie Braun-Inglis,(3) DNP, APRN, FNP-BC, AOCNP®, Brianna Hoffner,(4) MSN, ANP-BC, AOCNP®, FAPO, Maria Matta,(2) MPH, and Rana R. McKay,(1) MD

Oncology advanced practitioners (APs) work in collaboration with physicians to provide high-quality, specialized oncology care. Data are lacking on individual AP function within different practice settings, specifically around the prescr...

Pancreatic Cancer and the Family Connection: The Role of Advanced Practitioners in Screening and Educating Genetically At-Risk Individuals

Tracy Lowe,(1) PhD, MS, RN, Jane DeLuca,(1) PhD, MS, RN, CPNP-PC, Ludovico Abenavoli,(2) MD, PhD, MSc, and Luigi Boccuto,(1) MD

Pancreatic cancer is the third leading cause of cancer deaths in the United States. It has a 95% mortality rate within 5 years of the initial diagnosis. Pancreatic ductal adenocarcinoma is the most commonly diagnosed histotype. The avera...

Post-Transplant Cyclophosphamide for the Prevention of Graft-vs.-Host Disease in Allogeneic Hematopoietic Cell Transplantation: A Guide to Management for the Advanced Practitioner

Ekaterina Kachur, PharmD, BCOP, Jai N. Patel, PharmD, BCOP, CPP, Allison L. Morse, PharmD, BCOP, Donald C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP, and Justin R. Arnall, PharmD, BCOP

Cyclophosphamide remains a critical component to haploidentical transplant conditioning regimens. Post-transplant cyclophosphamide (PTCy) emerged as an effective component of graft-vs.-host disease (GVHD) prophylaxis in the nonmyeloablat...

Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review

Gabriela Mota-George, MSN, APRN, FNP-BC, AOCNP®, Ashley Martinez, DNP, APRN, FNP-BC, AOCNP®, CBCN, CPHQ, NEA-BC, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

As many as 24.7% of cancer patients are also parents to children younger than 18 years of age. This population faces unique challenges, and quality of life in parental cancer patients has not been well studied. This integrative review as...

Polycythemia Vera: Thinking Beyond the Hematocrit

Matthew Waggoner, MS, PA-C

Polycythemia vera is a Philadelphia chromosome–negative myeloproliferative neoplasm that results in increased myeloproliferation. It is a debilitating disease characterized by the overproduction of red blood cells, but it also can result...

Management of Ocular Toxicity in Patients Receiving Belantamab Mafodotin

Rebecca Lu, MSN, FNP-C, Ashley Morphey, RN, MSN, CCRP, Felicia Diaz, MSN, APRN, FNP-BC, AOCNP®, Jessica Chen, RN, MSN, OCN®, FNP-C, Azadeh Razmandi, OD, FAAO, and Tiffany Richards, PhD, ANP-BC, AOCNP®

While significant strides have been made in the treatment of multiple myeloma, treatment options remain limited and definite, and most patients ultimately succumb to their disease. The urgency for more treatment modalities remains, as pa...

Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’

Dallas R. Lawry, DNP, FNP-C, AOCNP®

Medical aid in dying is the act of prescribing lethal medications to a consenting patient who can self-ingest them with the intent of hastening their death. A majority of patients who utilize medical aid in dying are patients with termin...

Revolutionizing Cancer Treatment: Harnessing the Power of Biomarkers to Improve Patient Outcomes

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, FCCP, and Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC

There has been an increasing number of approvals for targeted therapies and immunotherapies in oncology in the past decade. This has changed the treatment paradigm for many solid tumors and hematologic malignancies, and therefore the out...

Biomarker-Driven Oncology Clinical Trials: Novel Designs in the Era of Precision Medicine

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, FCCP, and Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC

Oncology drug development historically has followed a path of sequential phase I, II, and III clinical trials using traditional trial designs, with the goal of achieving regulatory approval. These studies are often conducted with inclusi...

The Role of Biomarkers in Guiding Clinical Decision-Making in Oncology

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, FCCP, and Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC

Recent advances in molecular diagnostics have led to the characterization of an increasing number of actionable genomic alterations and immune-based signatures, which have facilitated the development of many highly effective cancer thera...

The Advanced Practitioner’s Role in the Rapidly Evolving Landscape of Precision Medicine

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, FCCP, and Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC

The advent of precision medicine targeting oncogenic mutations and other alterations has led to a paradigm shift in the treatment of many solid tumors and hematologic malignancies. For many of these agents, predictive biomarker testing i...

Tisotumab Vedotin Safety and Tolerability in Clinical Practice: Managing Adverse Events

Courtney R. Arn,(1) APRN-CNP, Kimberly J. Halla,(2) MSN, FNP-C, and Sally Gill,(3) RN (Hons)

Tisotumab vedotin-tftv, an antibody-drug conjugate indicated for the treatment of adult patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy, demonstrated clinically meaningful and durab...

Physical Activity in Multiple Myeloma: A Review of the Current Literature

Michaela Hillengass,(1) RN, ACSM-CPT, Janine Joseph,(1) MS, MBA, Jane McCarthy, and Jens Hillengass,(1) MD, PhD

One of the major issues patients with multiple myeloma (MM) suffer from is bone instability and the resulting difficulties that come along with it, such as pain and immobility. Few studies have been performed in this patient group to inv...

The Role of the Research Advanced Practice Provider in CAR T-Cell Clinical Trials

Ly Dsouza, PA-C, MPAS

In recent years, chimeric antigen receptor (CAR) T-cell therapy has emerged as an effective and potentially paradigm-shifting therapy for patients with refractory lymphoma and myeloma. This novel therapy involves engineering T cells to r...

Liquid Biopsy for Guiding Treatment Decisions in Advanced Non–Small Cell Lung Cancer

Gretchen Suk, DMSc, PA-C

Lung cancer is the leading cause of cancer-related deaths in the United States. The 5-year survival rates are poor with traditional therapy alone. New scientific advances in technology involving the human genome, including diagnostic too...

Meta-Analysis of Same-Day Pegfilgrastim Administration Stratified by Myelotoxic Febrile Neutropenia Risk and Tumor Type

Neda Alrawashdh,(1,2) PhD, PharmD, Ali McBride,(3) PharmD, MS, BCPS, Mok Oh,(1) PhD, PharmD, Nimer Alkhatib,(1) PhD, PharmD, Christopher Lee,(4) PhD, RN, FAHA, FAAN, FHFSA, Jennifer Martin,(5) MA, Karen MacDonald,(6) PhD, RN, and Ivo Abraham,(1,3,6) PhD, RN

Background: Pegfilgrastim is recommended to be administered at least 24 hours following the completion of chemotherapy, yet some clinicians use a same-day administration protocol. In this meta-analysis, we compared the incidence of chemo...

Ultrasound Evaluation of Carotid Artery Intima-Media Thickness: Effective Early Marker of Carotid Artery Disease in Adult Head and Neck Cancer Patients After Neck Radiation?

Whitney Randolph, APRN, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Radiation is a recommended front-line treatment for many adult head and neck cancer (HNC) patients. Early identification of radiation-associated carotid artery disease (CAD), a well-known phenomenon, can minimize long-term sequelae. This...

The Role of Echocardiogram and Cardiac Rhythm Analysis for Early Detection of Cardiac Amyloidosis

Elizabeth Hubert, APRN, FNP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Purpose: The purpose of this integrative review was to establish the role of cardiac rhythm analysis (electrocardiogram; EKG) and echocardiogram in increasing clinical suspicion for and earlier diagnosis of cardiac amyloidosis. Methods: ...

Barriers to Adherence to Cancer Treatments Among Head and Neck Cancer Patients

Jennifer Lynn Miller, PhD, RN, CMSRN, and Julianne Evers, DNP, APRN, AGACNP-BC, CCRN

Head and neck cancer patients often undergo a demanding treatment schedule requiring radiation and chemotherapy. Adherence to these treatment schedules is affected by several issues, including socioeconomic factors, characteristics of th...

Measuring Advanced Practice Provider Productivity at the National Comprehensive Cancer Network’s Member Institutions

Diana Krause(1), Karen Sharrah(2), Anne Gross(3), Danielle Bowers(3), Daniel Mulkerin(4), Nancy Brandt(4), Kate Kennedy(5), Annie Austin(5), Aaron Begue(6), Rose Bell(7), Cheryl Raczyk(7), Todd Pickard(8), Timothy Kubal(9), Dave Johnson(9), Kellyann Jeffries(10), Vanna Dest(11), Rory Randall(12), Jessica Sugalski(1), and Gabrielle Zecha(13)

Introduction: The utilization of advanced practice providers (APPs) in oncology has been growing over the last decade; however, there is no standard method for assessing an APP’s contributions to oncology care. Methods: The NCCN Best Pra...

Hemophilia A: Strategies for Improving Long-Term Holistic Management, Adherence, and Quality of Life

Miguel A. Escobar,(1) MD, Cindy Leissinger,(2) MD, and Guy Young,(3) MD

Hemophilia A is a rare inherited bleeding disorder characterized by a deficiency in factor VIII. The evolution of currently approved prophylaxis therapy in hemophilia A will be reviewed, including the clinical value of prophylaxis, real-...

Practical Management of the Venetoclax-Treated Patient in Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia

Matthew Waggoner,(1) MS, John Katsetos,(1) PA-C, Emilee Thomas,(1) MBA, MPH, PA-C, Ilene Galinsky,(2) BSN, MSN, ANP-C, and Heather Fox,(3) PA-C

Venetoclax is a potent oral, highly selective small-molecule inhibitor of the antiapoptotic B-cell lymphoma 2 protein approved for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma in treatment-naive patients (in combinati...

Practical Strategies for Advanced Practitioners Streamlining the Integration of Oncology Biosimilar Therapies Into Practice

Kelley D. Mayden,(1) DNP, APRN-FNP, AOCNP®, John M. Kelton,(2) PharmD, Joanne C. Ryan,(2) PhD, RN, and Ali McBride,(3,4) PharmD, BCPS, BCOP

In oncology practices across the United States, biosimilars—highly similar versions of licensed, innovator (reference) biological medicines—are currently emerging as more affordable therapeutic options. Only after a rigorous product deve...

Cardiovascular Adverse Events and Mitigation Strategies for Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor Therapy

Lisa Nodzon, PhD, APRN, AOCNP®, Anecita Fadol, PhD, FNP-BC, FAANP, FAAN, and Sara Tinsley, PhD, APRN, AOCN®

Cardiovascular (CV) risk mitigation is an important consideration in the management of chronic myeloid leukemia (CML) patients. Although BCR-ABL1 inhibition by tyrosine kinase inhibitors (TKI) has led to a significant improvement in prog...

Evidence-Based Criteria Supporting Early Discharge for Pediatric Patients With Osteosarcoma Receiving High-Dose Methotrexate: A Retrospective Chart Review

Erin Armideo, CRNP, MSN, BSN, RN, CPON, Shannon Froio, BSN, RN, Meredith Johnson, CRNP, MSN, BSN, RN, Alison Tardino-Gingrich, CRNP, MSN, BSN, RN, and Elizabeth Froh, PhD, RN

Purpose: The purpose of this study is to describe the outcomes following the implementation of an early discharge protocol for pediatric patients with osteosarcoma receiving high-dose methotrexate (MTX) to determine if the protocol safel...

Emerging Treatment Options for Advanced or Recurrent Endometrial Cancer

Kimberly Halla, FNP-C

Endometrial cancer is the most common cancer of the female reproductive organs. The American Cancer Society estimates that there will be over 65,950 new cases diagnosed in 2022. According to the National Comprehensive Cancer Network (NCC...

Antibiotic Therapy and Gastrointestinal Graft-Versus-Host Disease in the Allogeneic Stem Cell Transplantation Population

Jessica Thomas, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Purpose: Hematopoietic stem cell transplantation patients undergo rigorous courses of myeloablative chemotherapy that increase vulnerability for infections. Complications can arise in the form of graft-vs.-host disease (GvHD) manifesting...

Premedications for Cancer Therapies: A Primer for the Hematology/Oncology Provider

Amber Clemmons,(1,2) PharmD, BCOP, Arpita Gandhi,(3) PharmD, BCOP, Andrea Clarke,(2) PharmD, Sarah Jimenez,(2) APN-BC, AGACNP, AOCNP®, Thuy Le,(2) MD, and Germame Ajebo,(2) MD

Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, ca...

Telehealth Interventions for Supportive Management and Early Recognition of Treatment-Related Symptoms in Patients With Hematologic Malignancies

Chasity Yajima, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, DNP, APRN, ANP-C, NPD-BC, CPHQ, Diane Barber, PhD, APRN, ANP-BC, AOCNP®, FAANP, FAAN, and Joyce Dains, DrPH, JD, APRN, FNP-BC, FAANP, FAAN

Purpose: The purposes of this literature review were to (1) establish the utility of supportive telehealth interventions focusing on early identification of treatment-related symptoms in adult patients with hematologic malignancies, with...

CDK4/6 Inhibitors: Paving the Way for HR-Positive, HER2-Negative Early Breast Cancer

Kristi Orbaugh,(1) RN, MSN, RNP, AOCN®, Val R. Adams,(2) PharmD, FCCP, BCOP, FHOPA, and Theresa W. Gillespie,(3) PhD, MA, RN, FAAN

Cyclin-dependent kinase (CDK) 4/6 inhibitors are revolutionizing care for patients with advanced and metastatic hormone receptor–positive (HR+) and human epidermal growth factor receptor 2–negative (HER2–) breast cancer. These oral agent...

Early Detection of Vulvovaginal Graft-Versus-Host Disease: An Integrative Review

Payton L. Ten Hagen, DNP, APRN, FNP-C, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Introduction: Vulvovaginal graft-vs.-host disease (VVGvHD) is a condition caused by a T-cell mounted immune response after allogeneic hematopoietic stem cell transplant (alloHSCT), which can lead to sclerotic changes of the external geni...

A Study of Advanced Practice Provider Staffing Models and Professional Development Opportunities at National Comprehensive Cancer Network Member Institutions

Annie Austin,(1) Kellyann Jeffries,(2) Diana Krause,(3) Jessica Sugalski,(3) Karen Sharrah,(4) Anne Gross,(5) Danielle Bowers,(5) Daniel Mulkerin,(6) Nancy Brandt,(6) Aaron Begue,(7) Rose Bell,(8) Cheryl Raczyk,(8) Todd Pickard,(9) David Johnson,(10) Vanna Dest,(11) Rory Randall,(12) Gabrielle Zecha,(13) and Kate Kennedy,(1)

Introduction: The National Comprehensive Cancer Network (NCCN) Best Practices Committee created an Advanced Practice Provider (APP) Workgroup to develop recommendations to support APP roles at NCCN Member Institutions. Methods: The Workg...

Treatment Options for Germline BRCA-Mutated Metastatic Pancreatic Adenocarcinoma

Doreen Grzelak, NP-C, AOCN®, AGN-BC

Pancreatic cancer is the fourth leading cause of death from cancer in both men and women. Pancreatic cancer is typically diagnosed at an advanced stage and has an overall 5-year survival of approximately 9.3%. The National Comprehensive ...

Nipple-Sparing Mastectomy in Breast Cancer: Impact on Surgical Resection, Oncologic Safety, and Psychological Well-Being

Lisa Parks, MS, APRN-CNP, ANP-BC

Nipple-sparing mastectomy (NSM) is a surgical option to improve patient satisfaction with aesthetic outcome. It can be utilized to decrease body image disturbance by preserving the woman’s skin and areolar complex. Data for cancer treatm...

Management of Hematologic Adverse Events Associated With Immune Checkpoint Inhibitors

Barbara Barnes Rogers, CRNP, MN, AOCN®, ANP-BC, Carolyn Zawislak, MPAS, PA-C, and Victoria Wong, PA-C

Immune checkpoint inhibitors target suppressor receptors, including cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed cell death ligand 1 (PD-L1). The activated T cells are not a...

Ginseng for the Management of Cancer-Related Fatigue: An Integrative Review

Emily A. Lemke, DNP, AGPCNP-BC, AOCNP®

Background: Cancer-related fatigue (CRF) is one of the most prevalent, debilitating symptoms affecting a majority of patients with cancer worldwide. It can lead to poor compliance with anticancer therapy and discontinuation of treatment....

The Use of Real-World Evidence for Oral Chemotherapies in Breast Cancer

Kirollos Hanna,(1) PharmD, BCPS, BCOP, and Kelley Mayden,(2) MSN, FNP, AOCNP®

Almost all patients with breast cancer will eventually receive chemotherapy drugs, the majority of which are administered as IV infusions. Real-world evidence indicates that while current treatment paradigms vary considerably from guidel...

Chemotherapy Treatment Considerations in Metastatic Breast Cancer

Kirollos Hanna,(1) PharmD, BCPS, BCOP, and Kelley Mayden,(2) MSN, FNP, AOCNP®

Historically, metastatic breast cancer (MBC) was primarily treated with surgery and chemotherapy. To that end, a wide array of chemotherapy agents are currently available for the treatment of MBC. To date, there has been considerable pro...

Integration of Palliative Care in the Role of the Oncology Advanced Practice Nurse

Betty R. Ferrell,(1) RN, PhD, MA, FAAN, FPCN, CHPN, Rose Virani,(1) RNC, MHA, FPCN, Elinor Han,(1) BA, and Polly Mazanec,(2) PhD, ACNP-BC, AOCN®, FPCN, FAAN

Numerous organizations have cited the increasing demand for palliative care in oncology and the challenge of a limited workforce to deliver specialty palliative care. Advanced practitioners in oncology can provide generalist or primary p...

Patient-Reported Outcome Measures With Secondary Lower Limb Lymphedemas: A Systematic Review

Margit Eidenberger, PT Mag

Background: Patient-reported outcome measures are measures of patients’ health-related quality of life. They should be added to other lymphedema measurements. With an improved disease-free survival of secondary lower limb lymphedema, att...

Roadmap to the Enhanced Thoracic Surgical Journey

TaCharra Y. D. Woodard, MSN, APRN, ACNP-BC, AOCNP®, Carla M. Patel, MSN, APRN, ACNP-BC, and Garrett L. Walsh, MD

The Enhanced Recovery Program (ERP) is a comprehensive, multidisciplinary approach that directly impacts the functional recovery and quality of life of patients after surgery. Initiated in 2013 at The University of Texas MD Anderson Canc...

The Impact of Peripheral Cooling on Chemotherapy-Induced Peripheral Neuropathy: An Integrative Review

Bethany G. Sphar, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, DNP, APRN, ANP-C, NPD-BC, CPHQ, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent, potentially long-lasting side effect of select chemotherapies. It contributes to suboptimal chemotherapy dosing, and its symptoms negatively impact patients’ quality of li...

Pancreatic Ductal Adenocarcinoma: Characteristics of Tumor Microenvironment and Barriers to Treatment

Sujata Kane,(1) PA-C, Anne Engelhart,(1) ANP-BC, Jessica Guadagno,(1) PA-C, Aaron Jones,(1) ANP-BC, Innis Usoro,(2) and Edith Brutcher,(1) ANP-BC, AOCNP®

Pancreatic ductal adenocarcinoma remains a highly aggressive disease, with a 5-year relative survival rate of 10%. Numerous barriers to treatment exist, such as dense desmoplasia, infiltration of immune suppressor cells, inhibitory cytok...

Nausea and Vomiting Not Related to Cancer Therapy: Intractable Problem or Clinical Challenge?

Rita J. Wickham, PhD, RN

Purpose: Unlike therapy-related nausea and vomiting (chemotherapy or radiotherapy induced), nausea and vomiting (N/V) in patients with advanced cancer is often multicausal and thus presents unique challenges. Few professional guidelines ...

Phase 1 Clinical Trials in the Elderly: Enrollment Challenges

Carol Guarnieri, RN, MSN, FNP-C, and Daniel D. Von Hoff, MD, FACP, FASCO, FAACR

Cancer mostly affects older adults. Despite the increased incidence of cancer among older adults, they are underrepresented in oncology clinical trials. Such trials can provide patients with early access to promising interventions. Clini...

Risk Factors for Ifosfamide-Related Encephalopathy in Adult Cancer Patients: An Integrative Review

Amanda Lee Brink, DNP, APRN, FNP-BC, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Patients receiving ifosfamide as part of their cancer treatment are at risk for ifosfamide-related encephalopathy (IRE), a potentially serious adverse event affecting up to 60% of patients. Symptoms range from transient altered mental st...

Beyond CAR T-Cell Therapy: Continued Monitoring and Management of Complications

Victoria Reiser, RN, BSN, BMTCN, OCN®

Chimeric antigen receptor (CAR) T-cell therapy has recently emerged as a groundbreaking treatment for CD19-expressing hematologic malignancies and received rapid approval by the U.S. Food & Drug Administration. Tisagenlecleucel and a...

Optimizing Use of Newly Approved Agents for Acute Myeloid Leukemia

Nancy M. Nix, PharmD, BCPS, BCOP, and Allyson Price, MPAS, PA-C

Abstract Until recently, treatment advances in acute myeloid leukemia (AML) had been slow since the 1970s. However, in the past few years, as the understanding of the pathophysiology of AML has advanced, numerous treatments have been ap...

The Role of the Advanced Practitioner in Enhancing Outcomes

Nancy M. Nix, PharmD, BCPS, BCOP, and Allyson Price, MPAS, PA-C

Abstract Advanced practitioners (nurse practitioners, physician assistants, pharmacists, and other health-care providers) have become increasingly integral members of the oncology care team. The accelerated rate of approvals for new the...

AL Amyloidosis: Unfolding a Complex Disease

Rebecca Lu, MS, FNP, and Tiffany A. Richards, PhD, ANP-BC

Light chain (AL) amyloidosis is a rare plasma cell dyscrasia. An estimated 12,000 people live with the disease in the United States. AL amyloidosis occurs from the misfolding of proteins that deposit in organs (heart, kidneys, digestive ...

Aztreonam and Vancomycin for Initial Treatment of Febrile Neutropenia in Penicillin-Allergic Patients During Hematopoietic Stem Cell Transplantation

Steven Trifilio, RPh, and Jayesh Mehta, MD

Most patients who undergo hematopoietic stem cell transplantation develop neutropenic fever and are at high risk for developing potentially life-threatening infections. β-lactam antibiotics remain the cornerstone for initial empiric trea...

Immunoglobulin Light-Chain Amyloidosis: Clinical Presentations and Diagnostic Approach

Yi L. Hwa, DNP,(1) Teresa Fogaren, MSN, AGNP-C,(2) Allison Sams, AGPCNP-BC,(3) Douglas V. Faller, MD, PhD,(4) Dawn M. Stull, PharmD, BCOP,(5) Sara Thuenemann, RN, MSN, DHSc,(6) and Lisa Mendelson, MSN, AGPCNP-BC(7)

Abstract Systemic immunoglobulin light-chain (AL) amyloidosis is a rare disorder arising from a plasma cell clone that produces misfolded immunoglobulin light chains, which are deposited in various tissues and organs as amyloid fibrils....

Cardiac Toxicity and Anthracyclines: Mechanism, Interventions, and the Trouble With Troponin

Grace E. Thompson, MSN, AGACNP-BC, AGPCNP-BC, and Phyllis P. Wright, DNP, AGPCNP-BC, MPH

As cancer survivorship increases, clinicians need to become educated regarding the long-term effect of cancer treatments. Cancer therapeutics–related cardiac dysfunction (CTRCD) is one such sequela that contributes to significant morbidi...

The Advanced Practice Provider Perspective: Treating Patients With Immuno-Oncology Combination Therapy Across Tumor Types

Brianna Hoffner,(1) MSN, ANP-BC, AOCNP®, Renae Vaughn,(2) MSN, ANP-C, AOCNP®, Maureen Reed,(3) MSN, ANP-C, AOCNP®, and Melinda S. Weber,(4) DNP, RN, APN, AOCN®

Abstract A number of immune checkpoint inhibitors (ICIs) have been approved by the U.S. Food and Drug Administration (FDA) as immuno-oncology (IO) monotherapy for multiple solid and hematologic tumor types across various lines of therap...

Anti-CD19 CAR T-Cell Therapy for Adult Patients With Refractory Large B-Cell Lymphoma

Kathleen McDermott, RN, BSN, OCN®, BMTCN®, and Lauren Spendley, AGNP, MSN, AOCN®

Abstract Chimeric antigen receptor (CAR) T-cell therapies represent a new paradigm in targeted cancer therapy. T cells play a key role in immune surveillance, but tumors have developed multiple mechanisms for evading that surveillance. ...

CAR T-Cell Therapy: Adverse Events and Management

Sherry Adkins, RN, MSN, ANP-C

Abstract Chimeric antigen receptor (CAR) T-cell therapy is an exciting innovation in the treatment of cancer. However, CAR T-cell therapies have been associated with unique adverse events (AEs), including cytokine release syndrome (CRS)...

Educating Multidisciplinary Care Teams, Patients, and Caregivers on CAR T-Cell Therapy

Alix Beaupierre, RN, BSN, OCN®, Nicole Kahle, MS, RN, OCN®, BMTCN®, Rachel Lundberg, PA-C, MPAS, and Amy Patterson, MSN, APRN, AOCNS®, BMTCN®

Abstract Two anti-CD19 chimeric antigen receptor (CAR) T-cell therapies are approved for adults with relapsed or refractory large B-cell lymphoma after more than two lines of therapy. Although CAR T-cell therapy has demonstrated signifi...

Adverse Effects of Virus-Specific T-Cell Therapy: An Integrative Review

Heidi Z. Simmons, MSN, RN, FNP-C, Angela F. Bazzell, DNP, RN, FNP-BC, AOCNP®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC

Allogeneic hematopoietic stem cell transplant (HSCT) remains the mainstay in treating many hematologic malignancies. T-cell–depleted grafts designed to reduce graft-vs.-host disease (GVHD) may be complicated by severe viral infections th...

Meeting the Challenge of Immune-Related Adverse Events With Optimized Telephone Triage and Dedicated Oncology Acute Care

Brianna Hoffner, MSN, ANP-BC, AOCNP®, and Krista M. Rubin, MS, FNP-BC

This article is a part of a JADPRO certified supplement, Immuno-Oncology Therapy Essentials: Proactive Management of Immune-Related Adverse Events Table of Contents Immuno-Oncology Essentials: An Overview Meeting the Challenge of I...

PD-1/PD-L1 Inhibitors for Non–Small Cell Lung Cancer: Incorporating Care Step Pathways for Effective Side-Effect Management

Marianne J. Davies, DNP, MSN, RN, APRN, CNS-BC, ACNP-BC, AOCNP®

This article is a part of a JADPRO certified supplement, Immuno-Oncology Therapy Essentials: Proactive Management of Immune-Related Adverse Events Table of Contents Immuno-Oncology Essentials: An Overview Meeting the Challenge of I...

Checkpoint Inhibitor Immunotherapy for Head and Neck Cancer: Incorporating Care Step Pathways for Effective Side-Effect Management

Casey Fazer, PA-C

This article is a part of a JADPRO certified supplement, Immuno-Oncology Therapy Essentials: Proactive Management of Immune-Related Adverse Events Table of Contents Immuno-Oncology Essentials: An Overview Meeting the Challenge of I...

Immune-Related Adverse Events From Immunotherapy: Incorporating Care Step Pathways to Improve Management Across Tumor Types

Laura S. Wood, RN, MSN, OCN®

This article is a part of a JADPRO certified supplement, Immuno-Oncology Therapy Essentials: Proactive Management of Immune-Related Adverse Events Table of Contents Immuno-Oncology Essentials: An Overview Meeting the Challenge of I...

Botulinum Toxin for Side-Effect Management and Prevention of Surgical Complications in Patients Treated for Head and Neck Cancers and Esophageal Cancer

Leah Shaw, MSN, RN, AGPCNP-BC, AOCNP®, Angela F. Bazzell, DNP, RN, FNP-BC, AOCNP®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP

Abstract The management of head and neck cancers (HNC) and esophageal cancer (EC) is complex and often involves multiple modalities of treatment, including chemotherapy, radiation therapy, and surgery. The side effects associated with t...

Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know

Nadia E. K. DePaola, MS, PA-C, and Heather Coggins, MS, PA-C

Abstract Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a rare peripheral T-cell lymphoma, first reported in 1997. It is pathologically confirmed as a CD30-positive, anaplastic lymphoma kinase (ALK)–negative ALCL...

Potential of Biosimilars to Increase Access to Biologics: Considerations for Advanced Practice Providers in Oncology

Sara M. Tinsley,(1) PhD, ARNP, AOCN®, Carolyn Grande,(2) CRNP, AOCNP®, Karin Olson,(3) PhD, PA-C, Leah Plato,(4) PA-C, MPH, CCRP, and Ira Jacobs,(5) MD, JD, MBA, FACS

Abstract Biosimilars are biologic products that are highly similar, but not identical, to a licensed reference (or “originator”) biologic product. These agents have the potential to provide efficiencies and improve access to treatment f...

Diagnosis, Evaluation, and Surgical Management of Melanoma

Brianna Hoffner, MSN, ANP-BC, AOCNP®, and Christan G. Bartsch, MSHS, PA-C, MPH

Abstract Melanoma accounts for 5.3% of all new cancer diagnoses, with increasing rates over the past 4 decades. Risk factors include multiple nevi, family history, sun exposure, immunosuppression, and environmental exposure. Ongoing pub...

Harnessing the Immune System in the Treatment of Melanoma

Suzanne McGettigan, MSN, CRNP, AOCN®

Abstract Melanoma has long been considered an immunogenic cancer. Early treatment options for melanoma therapy focused on the use of cytokines as a means of stimulating the immune system; these agents were used as single agents or in co...

BRAF/MEK Inhibition in Melanoma: An Update

Lisa A. Kottschade, APRN, MSN, CNP, and Kathleen M. Madden, RN, MSN, FNP-BC, AOCNP®, APHN

Abstract Melanoma accounts for significant mortality, and its incidence continues to rise. Extensive research regarding the molecular basis of melanoma has identified a critical role for the aberrantly activated MAPK pathway in its path...

Mutations Beyond BRAF V600

Mollie Reed, MSN, ACNP-BC

Abstract Among mutations in melanoma, BRAF V600 mutations have historically attracted the most attention and research. However, NRAS, GNAQ, c-KIT, NF1, and atypical BRAF mutations, although less common, warrant identification and consid...

Melanomas of Noncutaneous Origin: Diagnosis, Treatment, and Outcomes

Lisa A. Kottschade, APRN, MSN, CNP

Abstract The most common presentation of melanoma is that of a primary skin lesion; however, there is a unique subset of patients who will present with rare and unique clinical circumstances requiring acute attention with respect to dia...

Supportive Care and Management of Treatment-Related Adverse Effects From Immune Checkpoint Inhibitors and Targeted Therapies in Melanoma

Krista M. Rubin, MS, FNP-BC, and Lisa A. Kottschade, APRN, MSN, CNP

Abstract Molecularly targeted agents, and notably, the immune checkpoint inhibitors, are now considered standard therapies for the treatment of advanced melanoma and have forever changed the treatment paradigm for this difficult-to-trea...

Drug-Drug Interactions in Melanoma

LeAnn B. Norris, PharmD, FCCP, BCPS, BCOP

Abstract Tyrosine kinase inhibitors are indicated for the treatment of a variety of malignancies, but are used commonly in patients with advanced melanoma. Most are also substrates for various efflux transporters, including P-glycoprote...

Systemic Treatments for Lung Cancer Patients Receiving Hemodialysis

Tzewah V. Leung, PharmD, BCOP, Mitchell E. Hughes, PharmD, BCPS, BCOP, Christine G. Cambareri, PharmD, BCPS, BCOP, Daniel J. Rubin, PharmD, and Beth Eaby-Sandy, MSN, CRNP, OCN®

Abstract Chemotherapy, and now targeted therapies and immunotherapies, are widely used for the management of patients with all stages of lung cancer. Some challenges present when patients are receiving concomitant hemodialysis for vario...

Hypercalcemia of Malignancy

Kaitlin L. Feldenzer,(1) DNP, RN, OCN®, and Jessica Sarno,(2) MSN, ACNP-BC, AOCNP®

Abstract Hypercalcemia of malignancy (HCM) is a common concern in patients being treated for cancer, affecting over a quarter of this population. There are multiple causes of HCM, including humoral HCM, osteolytic HCM, ectopic hyperpara...

Enhanced Recovery After Surgery

Lisa Parks,(1) MS, RN, CNP, Meghan Routt,(2) MSN, ANP/GNP-BC, AOCNP®, and Allison De Villiers,(1) MSN, RN, OCN®, ACNS-BC

Abstract Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to achieve early recovery for patients undergoing major surgical procedures. Meta-analyses, randomized controlled trials, and large pros...

Iron Overload in Myelodysplastic Syndromes: Pathophysiology, Consequences, Diagnosis, and Treatment

Abstract Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic neoplasms varying in severity affecting one or more lines of hematopoiesis. Ineffective erythropoiesis results in dysregulation of iron metabolism. Most M...

Management of Advanced Bladder Cancer: An Update

Abstract Bladder cancer is the sixth most common cancer in the United States; therefore, the majority of clinicians working in the oncology setting will care for this patient population. Unfortunately, treatment plans, especially in the...

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Abstract Cardio-oncology is a subspecialty of cardiology. It was created to address oncology data indicating that newly developed drugs for cancer treatment were having unanticipated cardiac side effects. Cardio-oncology designs primary...

Acute Promyelocytic Leukemia: A Summary

Abstract Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia. The disease is characterized by a chromosomal abnormality involving translocation between chromosomes 15 and 17. Current therapy has advanced to incl...

Drug-Drug Interactions, Safety, and Pharmacokinetics of EGFR Tyrosine Kinase Inhibitors for the Treatment of Non–Small Cell Lung Cancer

Abstract Inhibitors of the epidermal growth factor receptor (EGFR) are important treatment options for non–small cell lung cancer (NSCLC) patients with activating EGFR mutations. Erlotinib, gefitinib, afatinib, and osimertinib are appro...

Combination Therapies 
in Advanced, Hormone 
Receptor–Positive Breast Cancer

About 17% of women with breast cancer have locally advanced or metastatic disease at the time of diagnosis, and 30% to 40% of women diagnosed with early-stage disease will eventually have recurrence. The majority of breast cancers expres...

Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner

Abstract Biosimilar agents are biologic products that have been shown to be “highly similar” to an already approved reference biologic product. Their integration into clinical practice has the potential to significantly decrease costs f...

Managing Tumor Lysis Syndrome in the Era of Novel Cancer Therapies

Abstract  Tumor lysis syndrome (TLS) is a potentially life-threatening emergency that can develop rapidly after the release of intracellular contents from lysed malignant cells. The advent of novel and targeted therapies that have impro...

Cancer Pain Management: Opioid Analgesics, Part 2

Opioid analgesics are the cornerstone of moderate to severe cancer pain management, and do not have ceiling doses unless unmanageable adverse effects occur. Oral, short-acting pure μ agonists such as morphine are most frequently used, bu...

Cancer Pain Management: Comprehensive Assessment and Nonopioid Analgesics, Part 1

Pain is still undertreated and thus a significant problem for at least half of all cancer patients. Inadequately managed cancer pain may cause significant morbidity and even affect mortality, as well as patient quality of life. One endur...

Cancer Care: Supporting Underserved and Financially Burdened Family Caregivers

Abstract Family caregivers who provide care for a loved one with advanced cancer suffer physically and psychologically from the care demands of a family member with high symptom burden and a poor prognosis. Often, family members are als...

Comparison of Outcome Measures for Traditional and Online Support Groups for Breast Cancer Patients: An Integrative Literature Review

Abstract Despite widespread use of support groups in the breast cancer patient population, there are heterogeneous outcome measurements and inconsistencies in their perceived benefits. The purpose of this integrative literature review i...

Advanced Care Provider and Nursing Approach to Assessment and Management of Immunotherapy-Related Dermatologic Adverse Events

Abstract Advanced care providers (ACPs) and nurses are fundamental players in the assessment and management of immunotherapy-related dermatologic adverse events (irdAE). Pembrolizumab, nivolumab, and ipilimumab are approved for unresect...

Managing Constipation in Adults With Cancer

Abstract Constipation is common in individuals with cancer, occurring in almost 60% of patients overall. The incidence increases in patients with advanced disease, particularly in those receiving opioid analgesics or medications with an...

Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) comprise a group of diverse clonal hematopoietic stem cell malignancies that are characterized by ineffective hematopoiesis and progressive bone marrow failure. Clinical symptoms are generally nonspecific....

Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications

Despite more intensive therapy, high-risk neuroblastoma continues to be a challenging disease to treat. Postconsolidation immunotherapy has been studied for many years and has proven to be effective in clinical trials. Immunotherapy has ...

Understanding and Managing Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Patients With Advanced Melanoma

The immune checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab represent a substantial improvement in treating advanced melanoma but are associated with adverse events (AEs) likely related to general immunologic enhancement. T...

Optimizing Communication and Adherence to Iron Chelation Therapy From Diagnosis to Treatment in Patients With Myelodysplastic Syndromes

Abstract Myelodysplastic syndromes (MDS), a heterogeneous group of blood diseases, are usually diagnosed in older individuals, with a median age at diagnosis of more than 70 years. Anemia is a common symptom in patients with MDS and may...

Management Strategies for Adverse Events Associated With EGFR TKIs in Non–Small Cell Lung Cancer

Abstract New advances in the treatment of non–small cell lung cancer (NSCLC) have afforded patients longer progression-free survival times, but these therapies are also associated with specific side effects that may not be seen with che...

Idelalisib: Practical Tools for Identifying and Managing Adverse Events in Clinical Practice

Abstract Idelalisib is a first-in-class oral selective inhibitor of phosphatidylinositol 3-kinase delta, which is selectively expressed in hematopoietic cells, where it is critical to B-cell receptor signaling and B-cell development and...

Clinical Management of Bowel Dysfunction After Low Anterior Resection for Rectal Cancer

Abstract The American Cancer Society estimated that 39,610 new cases of rectal cancer were diagnosed in the United States in 2015. Surgery is the primary treatment for rectal cancer, with the majority of patients undergoing sphincter-pr...

How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know

Abstract The immune system plays an active role in controlling and eradicating cancer. T cells, an essential component of the adaptive immune system, have a number of surface receptors (called “checkpoints”) that can help either to sust...

Biomarkers/Molecular Targets, Immunotherapy, and Treatments for Non–Small Cell Lung Cancer

Abstract For decades, the prognosis for patients with advanced-stage non–small cell lung cancer (NSCLC) was bleak, with chemotherapy offering limited benefit and much toxicity. Now, with mutational testing, new generations of targeted t...

Effectiveness of Granulocyte Transfusions in Neutropenic Adult Oncology Patients: A Comprehensive Review of the Literature

Among patients with cancer, many factors can cause severe and persistent neutropenia, leading to increased morbidity and mortality. For patients with neutrophil deficiency, replacement with granulocyte transfusion (GTX) seems a rational ...

Bosutinib Therapy in Patients With Chronic Myeloid Leukemia: Practical Considerations for Management of Side Effects

Abstract The past decade has witnessed great advances in the treatment of chronic myeloid leukemia (CML), brought about in large part by the development of BCR-ABL tyrosine kinase inhibitors (TKIs). Bosutinib joins the armamentarium of ...

Novel Uses for Lipid-Lowering Agents

Abstract Statin use leads to a reduction in the downstream products of the mevalonate pathway. Knowledge of this pathway has led scientists to investigate the role of statins in cancer prevention and treatment. Statins appear to possess...

Tyrosine Kinase Inhibitors for the Treatment of Chronic-Phase Chronic Myeloid Leukemia: Long-Term Patient Care and Management

Several tyrosine kinase inhibitors (TKIs) are now approved for the treatment of chronic myeloid leukemia in chronic phase. The efficacy of these drugs has been repeatedly demonstrated, as has their tolerability in most patients. However,...

Managing Patients With Myelofibrosis in the Era of Janus Kinase Inhibitors

Abstract Myelofibrosis, a rare, chronic myeloproliferative neoplasm associated with progressive bone marrow fibrosis and extramedullary hematopoiesis, is a life-shortening disease with a heterogeneous clinical presentation that poses si...

Ibrutinib: Implications for Use in the Treatment of Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

Abstract Bruton’s tyrosine kinase (BTK) is expressed in B-cell malignancies, playing an important role in B-cell receptor (BCR) signaling and offering a promising new strategy for the development of targeted drugs. Malignant B cells in ...

Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients?

Historically, randomized controlled trials (RCTs) have shown an increased risk of recurrence and mortality among women who have used primarily oral HRT after breast cancer. However, many of these studies have had design flaws that may im...

Shared Mental Models of Provider Roles in Cancer Survivorship Care

In 2012, the United States had an estimated 13.7 million cancer survivors, with a projected increase to 18 million by 2022. Little consensus exists regarding provider roles in cancer follow-up care. The purpose of this integrative review...

The Consequences of a BRCA Mutation in Women

Abstract Approximately 5% to 10% of breast cancer cases and 11% to 18% of ovarian cancer cases are a result of a mutation in the BRCA1 and BRCA2 genes, known as hereditary breast and ovarian cancer (HBOC). An inherited mutation in eithe...

The Toxicity and Benefit of Various Dosing Strategies for Interleukin-2 in Metastatic Melanoma and Renal Cell Carcinoma

Abstract Interleukin-2 (IL-2) therapy has been used with success in curing meta­static renal cell carcinoma and melanoma in a small minority of patients. However, the benefits can be accompanied by severe toxicity. This review of the li...

Thyroid Disorders in the Oncology Patient

Abstract Thyroid disease and cancer diagnoses are common conditions likely to coexist. Optimal management requires appropriate diagnostic testing and consideration of a number of factors, including overall health status and prognosis. H...

Biosimilars in the United States: Considerations for Oncology Advanced Practitioners

Abstract Biosimilars will enter the US market soon, potentially lowering costs and increasing patient access to important oncology biologics. Biosimilars are highly similar, but not identical, to their reference product. Subtle variatio...

Romidepsin for the Treatment of Peripheral T-Cell Lymphoma

Peripheral T-cell lymphomas (PTCLs) are a rare, heterogeneous group of T-cell– or natural killer cell–derived non-Hodgkin lymphomas. The majority of patients with PTCL experience an aggressive disease course and poor overall survival. Hi...

Pain Prevention Using Head and Neck Cancer as a Model

Pain is a common and often debilitating consequence of cancer and its treatment. Efforts to improve pain management for patients diagnosed with cancer have not resulted in widespread patient reports of acceptable management of pain. Pati...

Managing Side Effects of Vemurafenib Therapy for Advanced Melanoma

Abstract Somatic point mutations in the BRAF gene have been found in approximately 50% of melanomas. BRAFV600E, the most common mutation, results in the constitutive activation of BRAFV600E kinase, sustaining MAPK signaling and perpetua...

Immune Checkpoint Blockade: A New Paradigm in Treating Advanced Cancer

Abstract The approval of the immune checkpoint inhibitor ipilimumab for the treatment of advanced melanoma in 2011 spearheaded the development of other anticancer therapies with immune mechanisms of action, including other immune checkp...

Treatment Considerations for the Management of Patients With Hormone Receptor–Positive Metastatic Breast Cancer

Breast cancer is among the most commonly diagnosed cancers in the United States. Despite treatment, 30% to 40% of women with early-stage or localized invasive breast cancer will eventually develop metastatic disease. Women with metastati...

Improving Palliative Cancer Care

Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality ca...

Targeted Therapies in Breast Cancer: Implications for Advanced Oncology Practice

Abstract The systemic therapeutic management of breast cancer has undergone significant transformation in the past decade. Without targeted therapies, conventional treatment with cytotoxic agents has reached the limit of its potential i...

The History and Physical in Cancer Care: A Primer for the Oncology Advanced Practitioner

Abstract Advanced practitioners (APs) specializing in cancer care will most likely need to perform or participate in obtaining the history and physical (H & P) of a new patient. The core infrastructure of the history-taking and phys...

Approaches to Managing Safety With Lenalidomide in Hematologic Malignancies

Abstract Lenalidomide is an oral immunomodulatory agent approved in relapsed multiple myeloma with dexamethasone, for transfusion-dependent anemia in myelodysplastic syndrome associated with deletion 5q, and in relapsed/progressive mant...

Lessons Learned in Cancer Care Communication

Title: Communicating With Cancer Patients Author: John F. Smyth, MD Publisher: CRC Press Publication date: October 14, 2013 Price: $39.95 paperback, 100 pages; $27.00 e-book More information: www.crcpress.com

Functional Morbidity Following Latissimus Dorsi Flap Breast Reconstruction

Abstract According to the National Institutes of Health, more than 230,000 new cases of breast cancer will be diagnosed in 2014 alone. Following mastectomy, several reconstructive options exist for women with breast cancer. The timing a...

Innovative Agents in Multiple Myeloma

Abstract Multiple myeloma (MM) remains an incurable cancer of the bone marrow plasma cells. However, the overall survival of patients with MM has increased dramatically within the past decade. This is due, in part, to newer agents such ...

Distress Screening in Chronic Disease: Essential for Cancer Survivors

Distress is a psychological state that is often observed in patients with chronic disease. Many cancers are considered chronic in nature, with patients experiencing long, disease-free states and intervals of metastatic disease. Distress ...

Information Needs Priorities in Patients Diagnosed With Cancer: A Systematic Review

Information-sharing is an integral part of cancer care. Several studies have examined the information needs of patients with various types of cancer. However, the priorities of information needs among patients with cancer have not been r...

Predictors of Cervical Cancer Screening Adherence in the United States: A Systematic Review

Cervical cancer incidence rates have decreased dramatically since the implementation of the Papanicolaou (Pap) smear. Nevertheless, the American Cancer Society (ACS) estimates for 2013 predicted more than 12,000 new cases of cervical can...

Olanzapine: An Antiemetic Option for Chemotherapy-Induced Nausea and Vomiting

Despite the appropriate use of pharmacologic and nonpharmacologic preventative measures, chemotherapy-induced nausea and vomiting (CINV) can be debilitating and can decrease quality of life for many patients. In addition, patients may be...

Ceftazidime for Neutropenic Fevers: Is It Still an Appropriate Choice?

Infection continues to rank as a primary cause of treatment-related mortality in patients with cancer. For patients with neutropenic fevers, immediate empiric treatment with antibiotics is standard care. However, which specific antibioti...

Lung Cancer Screening With Low-Dose CT: Its Effect on Smoking Behavior

Lung cancer screening provides an opportunity for smoking cessation interventions. A review of the literature found that smokers who participated in lung cancer screening had a higher smoking cessation rate compared with smokers in the g...

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors

Herbs, vitamins, and other natural health products are being used by cancer patients and survivors with increasing prevalence in the United States. These complementary and alternative medicine (CAM) products, which are also referred to a...

Novel Agents for the Treatment of Multiple Myeloma: Proteasome Inhibitors and Immunomodulatory Agents

The integration of novel agents into the treatment of multiple myeloma (MM) has shifted the focus from an incurable disease to one that is chronic, with a realistic hope of someday achieving a cure. Proteasome inhibitors and immunomodula...

Testing Women With Endometrial Cancer for Lynch Syndrome: Should We Test All?

Women with Lynch syndrome (LS) are at equal or higher risk for gynecologic cancers compared with their risk for colorectal cancer (CRC). Endometrial cancer (EC) often precedes CRC as patients’ sentinel malignancy. Identifying these patie...

Novel Agents for the Treatment of Multiple Myeloma: Proteasome Inhibitors and Immunomodulatory Agents

The integration of novel agents into the treatment of multiple myeloma (MM) has shifted the focus from an incurable disease to one that is chronic, with a realistic hope of someday achieving a cure. Proteasome inhibitors and immunomodula...

Complementary Strategies for the Management of Radiation Therapy Side Effects

Patients with cancer utilize complementary and alternative medicine (CAM) for a variety of purposes, one of which is the reduction of side effects of conventional treatment. With a large number of their patients using CAM, it is importan...

Optimizing Adherence to Adjuvant Imatinib in Gastrointestinal Stromal Tumor

The increasing use of patient-administered oral anticancer drugs is paralleled by new challenges in maintaining treatment adherence. These challenges are particularly significant with adjuvant therapies for prevention of disease recurren...

Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties ...

Hypnosis: Adjunct Therapy for Cancer Pain Management

Pain is a symptom associated with prolonged recovery from illness and procedures, decreased quality of life, and increased health-care costs. While there have been advances in the management of cancer pain, there is a need for therapeuti...

Efficacy of Palifermin in the Hematopoietic Stem Cell Transplant Setting

Palifermin is a recombinant human keratinocyte growth factor that stimulates proliferation and differentiation of epithelial cells. Palifermin’s biological activity exerts cytoprotective and healing effects that decrease cell injury caus...

Prevention and Management of Tumor Lysis Syndrome in Adults With Malignancy

Tumor lysis syndrome (TLS), an oncologic emergency that typically occurs after the treatment of a malignancy with chemotherapy and/or radiotherapy, is the result of extreme tumor cell lysis with the release of intracellular potassium, nu...

Screening for Prostate Cancer: The Debate Continues

Other than skin cancer, prostate cancer is the most frequently diagnosed cancer in men, and it is the second leading cause of cancer-related death for males in the United States. Screening for prostate cancer using prostate-specific anti...

Bisphosphonate-Related Osteonecrosis of the Jaw: Historical, Ethical, and Legal Issues Associated With Prescribing

The long-term effects of many drugs are unknown. Established risks are communicated to patients who participate in clinical trials during the informed consent process. However, unknown and unanticipated side effects of medications may oc...

Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications

Multiple myeloma accounts for approximately 1% of neoplastic diseases and 13% of hematologic cancers. Complications often associated with MM include neurologic and hematologic issues, infections, renal insufficiency, and bone involvement...

Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice

The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body ...

Incorporating Clinical Trial Data Into Daily Cancer Care

The objective of clinical trials is to determine the effectiveness and safety of specific interventions. Regulatory agencies, clinicians, and patients depend on clinical trials because they provide the most reliable information about tre...

Fertility Issues of Breast Cancer Survivors

In the United States, more women are diagnosed with breast cancer than any other type of cancer. More than 11,000 of these women will be younger than 40, and many of these women will want to have children in the future. A significant num...

Myeloid Toxicity of Cancer Treatment

Myelotoxicity is one of the most common treatment-related adverse events for patients receiving systemic antineoplastic therapy or radiotherapy to bone marrow–producing regions. Myeloid cytopenias, including neutropenia, thrombocytopenia...

Guide to Interpreting Disease Responses in Chronic Myeloid Leukemia

With the introduction of tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia, the course of the disease has been altered from an acute, rapidly progressive terminal disorder to a serious condition with high remission rat...

Dermatologic Toxicities in Epidermal Growth Factor Receptor and Multikinase Inhibitors

Targeted therapies have produced significant treatment advances for patients diagnosed with a variety of tumor types. These therapies are associated with unique dermatologic toxicities that may hamper treatment efforts and cause signific...

Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia

Important advances in the understanding of the molecular basis of chronic myeloid leukemia have resulted in the development of new therapies and changed the paradigm for managing this myeloproliferative disease. Translocation of chromoso...

Vaccination Recommendations for the Hematology and Oncology and Post–Stem Cell Transplant Populations

Vaccination is a simple yet important process used to prevent many infections in the general population. For patients with suppressed immune systems, especially those who are undergoing chemotherapy or who have undergone stem cell transp...

Neurotoxicity Associated With Cancer Therapy

Neurologic complications can result from direct or indirect effects of cancer therapy. Treatment toxicity may affect both the central nervous system and the peripheral nervous system. Early recognition of these toxicities plays an import...

Venous Thromboembolism in the Cancer Population: Pathology, Risk, and Prevention

Patients with cancer have an increased risk of developing venous thromboembolism (VTE) and the incidence of these events has been increasing over the past decade. Venous thromboembolic events include both deep venous thrombosis and pulmo...

Transition to a New Cancer Care Delivery System: Opportunity for Empowerment of the Role of the Advanced Practice Provider

The purpose of the study was to obtain an in-depth understanding of the perceptions of advanced practice providers (APPs) with respect to their current roles in the context of the transition to a new cancer care delivery system, as well ...

Cancer-Related Infections

Cancer-related infections are complex and remain a leading cause of cancer-related morbidity and mortality. Susceptibility to cancer-related infections is due to the nature of the malignancy and cancer treatments. Epidemiologic trends fo...

Updates on the Understanding and Management of Chemotherapy-Induced Nausea and Vomiting

Chemotherapy-induced nausea and vomiting (CINV) is a common adverse event for patients with cancer. Many advances over the past 2 decades have improved the treatment of CINV, thus increasing the quality of life of cancer patients. Unders...

Gastrointestinal and Hepatobiliary Toxicities of Cancer Treatments

Individuals undergoing multimodality treatments for cancer are at risk for treatment toxicities that can negatively impact the entire gastrointestinal (GI) tract and the liver. These toxicities can be short term or they can linger for ye...

Screening HIV-Infected Men for Anal Dysplasia and Cancer: Are Practice Guidelines Needed?

Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) have an increased risk of developing squamous cell carcinoma of the anus (SCCA) and precancerous anal dysplasia. Anal cancer precursor lesions may develop due to...

Inflammatory Breast Cancer: Breast Cancer Without a Lump

T.N. was a 45-year-old African American female who presented with right breast swelling, pain, skin changes, and redness for 2 weeks (Figure 1). She was initially treated with antibiotics for presumed mastitis by her primary care physici...

Cardiovascular Adverse Events Associated With Cancer Therapy

The increasing use of more complex multiagent treatments and multimodal delivery of antineoplastic therapies has resulted in a growing number of cardiovascular complications resulting in cardiotoxicity. These complications may manifest a...

Nutritional Management in Adult Hematopoietic Stem Cell Transplant

Hematopoietic stem cell transplant (HSCT) patients are at risk for and vulnerable to malnutrition throughout all phases of the transplant process. Patients can develop symptoms that make it difficult to maintain a balanced fluid, electro...

Pancreatic Cancer

Pancreatic cancer remains one of the most feared cancer diagnoses due to the poor prognosis associated with the majority of cases. Most patients present with distant metastases, and 5-year relative survival rates have changed very little...

Biomarkers in Non-Small Cell Lung Cancer: Opportunity and Challenge

Lung cancer, a major global public health issue, is the leading cause of cancer death in the United States. In spite of the importance of this disease, there has been only a 3% improvement in 5-year survival over the past 30 years. While...

Predictive Genetic Testing: Can Specialized Advanced Practitioners Quell Consumer Confusion?

It is currently common to see advertisements on television, in magazines, and on the Internet for genetic tests to evaluate one's own risk for cancer. Medical direct-to-consumer (DTC) marketing is not new to us—we are used to seeing adve...

Radical Prostatectomy for the Treatment of Moderate to Severe Lower Urinary Tract Symptoms in Organ-Confined Prostate Cancer

A diagnosis of prostate cancer in men who have moderate to severe lower urinary tract symptoms (LUTS) frequently results in a recommendation to undergo radical prostatectomy. The rationale for this recommendation is that removal of the p...

Biomarkers in Breast Cancer

Biomarkers offer great promise in the care of patients who have cancer. They can establish a more accurate and definitive diagnosis, and help identify patients most likely to respond to therapy, those most likely to experience disease re...

The Pathogenesis of Multiple Myeloma: Understanding the Mechanisms of the Bone Marrow Microenvironment

Multiple myeloma, a mature B-cell malignancy, is the second most common hematologic malignancy in the United States. Research has highlighted the importance of the bone marrow microenvironment in contributing to the pathogenesis of multi...

Biomarkers in Prostate Cancer

Prostate cancer represents the most common noncutaneous cancer in men in the United States. Although PSA testing with or without digital exam has led to increased prostate cancer detection, it continues to lack specificity, which leads t...

Translating Evidence-Based Research into Practice

The demand for a transformation of the health-care system has led to an emphasis on evidence-based practice (EBP) to ensure safe, quality care. The gap between research and translation into practice has resulted in the call for changes i...

Biomarkers in Colorectal Cancer: Implications for Nursing Practice

Confirming the diagnosis of cancer has largely been the role of the pathologist, through examination and evaluation of tumor tissue. An adjunct to this process is the identification of a tumor marker, which can be found in tumor tissue o...

Adherence to Oral Therapies for Cancer: Barriers and Models for Change

Adherence to orally administered cancer therapy is far from optimal. Theory-driven interventions are needed for optimal management of patients on oral anticancer regimens. Few models for assessing motivation, models for change theory, or...

Laboratory Measures for the Diagnosis, Clinical Management, and Evaluation of Treatment Response in Multiple Myeloma

Tumor markers include substances secreted by or in response to tumor cells and are measured in tissue or other body fluids. Biomarkers have been most widely used in the diagnosis and evaluation of treatment response in solid tumors, such...

Epidermal Growth Factor Receptor Inhibitors and Radiation Therapy in Head and Neck Cancer: Potential Management Strategies for Skin Reactions

Head and neck cancer remains a formidable disease entity. Many of the patients with this tumor type present with locally advanced disease, and although treatment options have increased significantly, improving survival, patients with hea...

Roles of the Clinical Nurse Specialist and Nurse Practitioner in Survivorship Care

Providing survivorship care for the over 20 million cancer survivors expected in the United States by 2020 will be a health-care challenge. The anticipated deficit in health-care providers will demand that follow-up care of this populati...

Biomarkers in Ovarian Cancer Screening

There are no effective early-detection modalities for epithelial ovarian cancer (EOC), the fifth leading cause of cancer death in women. However, the 5-year survival rate for women diagnosed with stage I disease is 90%, demonstrating the...

Risk Analysis in the Treatment 
of Hematologic Malignancies in the Elderly

Chronic lymphocytic leukemia (CLL), non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), acute myelogenous leukemia (AML), and myelodysplastic syndromes (MDS) represent the most common hematologic diseases in adults, with the majority of...

Clinical Assessment of Chemotherapy-Induced Peripheral Neuropathy: The Road Less Traveled

The cornerstone of treatment for many cancers includes chemotherapy agents known to induce peripheral neuropathy. Chemotherapy-induced peripheral neuropathy (CIPN) is a potential side effect of treatment for which few patients are prepar...

Scientific Advances in the Diagnosis and Risk Stratification of Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are a group of heterogeneous indolent B-cell malignancies that are largely incurable and occur most commonly in older adults. Chronic lymphocytic leukemia is the mos...

Monoclonal Antibodies in Chronic Lymphocytic Leukemia

Monoclonal antibodies that target CD20 and CD52 have been evaluated in the setting of chronic lymphocytic leukemia over the past 2 decades. Incorporating these agents into chemotherapy regimens has improved disease control, making chemoi...

Small Molecules in Chronic Lymphocytic Leukemia: Novel Targets, New Challenges

The treatment of chronic lymphocytic leukemia (CLL) is in a state of transformation owing largely to an improved understanding of the pathways and molecular targets in normal B-cell development, the role aberrant pathways play in the dev...

Emerging Therapies in Chronic Lymphocytic Leukemia: Current Trials

Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in adults in the Western hemisphere, and in 2017, it is expected to be diagnosed in 20,110 people, with 4,660 dying of this disease. The median age at diagnosis of CLL is ...

Risk-Adapted Treatment Strategies for Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is one of the most common types of leukemia among elderly patients. The disease can behave quite heterogeneously, as certain CLL patients will experience an indolent course, whereas others endure an agg...

Supportive Care and Management of Treatment-Emergent Adverse Events in Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a disease of the elderly, with 71 years as the median age at diagnosis. Many symptoms that patients with CLL experience are related to the disease but may also be associated with its treatment. Autoi...

The Older Adult Living With Chronic Lymphocytic Leukemia: Implications for Oncology Providers, Patients, and Caregivers

Chronic lymphocytic leukemia (CLL) is a disease most common in older adults, with a median age at diagnosis of 71 years. Chronic lymphocytic leukemia is considered an incurable but highly treatable disease, and it is characterized by var...

The Role of the Advanced Practitioner in Maintaining Adherence in Patients on Oral Oncolytics

Abstract In past decades, oral formulations of medications used in the treatment of cancer have become increasingly prevalent. This can be a significant benefit for patients, as it eliminates the need for frequent trips to the infusion ...

The Emerging Role of Molecular Testing in Ovarian Cancer

The post-genomic era has opened the door for personalized cancer treatments, and the trend of discovery is moving forward to identify more stratified biomarkers to accurately predict the progression of disease, as well as efficacy biomar...

The Emerging Role of Molecular Testing in Non–Small Cell Lung Cancer

In recent years, the role of molecular testing in non–small cell lung cancer (NSCLC) has rapidly grown. The US Food and Drug Administration (FDA) has approved several new medications to treat patients with genetic alterations over the pa...

Lynch Syndrome and Immunotherapy

Lynch syndrome is a hereditary cancer syndrome that accounts for most inherited forms of endometrial and colorectal cancers and also increases the lifetime risk of developing many other types of malignancies including ovarian cancer. Lyn...

BRCA-Related Ovarian Cancers and the Role of PARP Inhibitor Therapy

Significant progress has been made in the management of hereditary ovarian cancer, given advancements in genetic screening, risk assessment, and treatments. Women with hereditary breast and ovarian cancer (HBOC) syndrome, which is caused...

Diagnosis of Lung Cancer

Over the past 10 years, there have been significant advances in the diagnosis of lung cancer. Screening of high-risk patients with computed tomography scans and genomic biomarkers aid in the diagnosis of lung cancer patients at earlier s...

Fundamentals of Lung Cancer Staging

Lung cancer is the leading cause of cancer-related mortality in the United States and the world. The treatment of non–small cell lung cancer (NSCLC) is dependent on adequate staging of disease at diagnosis. Computed tomography (CT) and p...

Predictive and Prognostic Biomarkers and Related Therapies in Non–Small Cell Lung Cancer

Non–small cell lung cancer (NSCLC) is the leading form of lung carcinoma in the United States. Systemic chemotherapy has remained the mainstay of treatment; however, advances in the identification of driver mutations have allowed the dev...

Supportive Care and Management of Treatment-Emergent Adverse Events With Targeted Therapy in Non–Small Cell Lung Cancer

This article provides a summary of current approaches to the management of adverse effects from targeted therapies for non–small cell lung cancer (NSCLC). Agents included in this section are categorized as epidermal growth factor recepto...

Emerging Biomarkers in Non–Small Cell Lung Cancer

Since the identification of epidermal growth factor receptor (EGFR) mutations in a subset of non–small cell lung cancers and the concomitant success of front-line EGFR inhibitors in treating cancers with these mutations, interest in iden...

Immunotherapy Mechanisms of Action in Non–Small Cell Lung Cancer

Immunotherapy is now a mainstay of therapy for several different types of malignancies. Non–small cell lung cancer (NSCLC) has been one of the first solid tumors to show promising clinical trial results in the use of immunotherapy, speci...

Unleashing the Immune System With Checkpoint Inhibitors in Non–Small Cell Lung Cancer: Clinical Review of Adverse Events

Immunotherapy checkpoint inhibitors have dramatically changed our management of metastatic non–small cell lung cancer (NSCLC). Efficacy data have supported immune checkpoint inhibitors as potential first-line options as monotherapy or in...

Emerging Therapies in Non–Small Cell Lung Cancer: Clinical Trials With Novel Agents

Non–small cell lung cancer (NSCLC) continues to be the leader in cancer-related deaths in the United States. Although local therapies such as surgery and special types of radiation appear to deliver the best chance for cure or remission...

Sequencing of Treatment and Integration of Clinical Trials

Abstract This article provides an overview of current approaches for the treatment of newly diagnosed multiple myeloma using approved agents, including bortezomib and lenalidomide. Clinical development of drugs for multiple myeloma, and...

Palliative Care in Multiple Myeloma

Abstract With the advent of more effective treatments for multiple myeloma, many patients are maintained longer on chronic therapy and thus have greater need for palliative care to manage symptoms of the disease and side effects of ther...

Risks for Chemotherapy-Induced Nausea and Vomiting: Capturing Relevant Data

Abstract Much of the success achieved in managing the side effects of chemotherapy-induced nausea and vomiting (CINV) centers on the evolving knowledge base regarding the physiology of vomiting. Increasing awareness of multiple afferent...

Actualizing Standards of Care for Chemotherapy-Induced Nausea and Vomiting

Abstract Despite the development of newer antiemetics such as serotonin (5-HT3) and neurokinin-1 (NK-1) receptor antagonists, prevention of chemotherapy-induced nausea and vomiting (CINV) still presents a challenge to many patients and...

Managing Chemotherapy-Induced Nausea and Vomiting: Past, Present, and Future

Abstract Although current antiemetic agents, either singularly or in combination, have had substantial positive effects on controlling chemotherapy-induced nausea and vomiting (CINV), there are still concerns regarding how well advanced...

Relapsed or Relapsed/Refractory Multiple Myeloma

Multiple myeloma (MM) is a malignant plasma cell disorder with potential secondary organ effects including renal, bone, and bone marrow effects as well as neurologic and immune dysfunction. Diagnostic evaluation of MM includes laboratory...

The Side Effect Profile of Carfilzomib: From Clinical Trials to Clinical Practice

Treatment of patients with relapsed and/or refractory multiple myeloma (RR MM) is challenging due to the heterogeneity of the disease, patient comorbidities, and side effects of individual treatments. Carfilzomib, a selective proteasome ...

Treatment With Carfilzomib: A Promising Future for Multiple Myeloma

The survival outlook for patients with multiple myeloma (MM) has improved over the past decade; however, even with access to newer therapies, all patients will eventually relapse and progress. Carfilzomib is a selective proteasome inhibi...

Monitoring, Treatment Resistance, and Treatment Failure in CML: Breaking Barriers to Improved Outcomes

Despite the dramatic success seen with tyrosine kinase inhibitors (TKIs) in most patients with chronic myeloid leukemia (CML), some patients still develop resistance or intolerance and need alternative therapies. Monitoring response to T...

Current Approaches to the Diagnosis and Management of Myelodysplastic Syndromes

The myelodysplastic syndromes (MDS) are a group of heterogeneous myeloid stem-cell malignancies most prevalent in the seventh and eighth decades of life. Since most patients are elderly, are treated as outpatients, and often have comorbi...

Risk Stratification and Management of Acute Myeloid Leukemia

Acute myeloid leukemia (AML), a heterogeneous group of distinct clonal malignancies, accounts for 80% of acute leukemias in adults. The incidence of AML among US adults is increasing, particularly in those older than 60. Risk factors for...

Update on the Management of Follicular Lymphomas

Follicular lymphomas (FLs), the second most common type of non-Hodgkin lymphoma in the United States, are typically diagnosed in older patients. Grades 1 and 2 FLs, which account for about 75% of all FLs, are commonly indolent and incura...

Management of Multiple Myeloma and Serious Side Effects

Multiple myeloma (MM) is a B-cell malignancy arising from neoplastic proliferation of monoclonal plasma cells. The majority of patients are men, and the median age at diagnosis is 71 years. Information provided by laboratory and radiolog...

Oral Mucositis: Addressing the Causes, Challenges, and Clinical Management

Oral mucositis remains one of the most painful and debilitating side effects of cancer therapy. A working knowledge of the risk factors for oral mucositis and oral cavity assessment protocols is essential to early identification of signs...