Developmental Therapeutics

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...

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...

New Frontiers: The Role of CAR T-Cell Therapy in Multiple Myeloma

Alli McClanahan, APRN, and Megan Spychalla, PA-C

Multiple myeloma remains the second most common hematologic malignancy, and relapse rates are high, with refractory disease common with each relapse. Chimeric antigen receptor (CAR)–modified T cells are a promising new treatment, and at ...

An AP Perspective on Infusion Reactions in the Era of Immunotherapy

Carrie Peterson, DNP, RN, AGNP-c

As cancer care advances, creative uses for immunotherapy continue to be developed, but it is also important to be cognizant of the risk for infusion reactions. At JADPRO Live Virtual 2021, Carrie Peterson, DNP, RN, AGNP-c, reviewed the d...

Immunotherapy for the Treatment of Triple-Negative Breast Cancer

Sara M. Tolaney, MD, MPH, and Lindsay Shaw, ANP-BC, AOCNP®

At JADPRO Live Virtual 2021, Sara M. Tolaney, MD, MPH, and Lindsay Shaw, ANP-BC, AOCNP®, presented on recent clinical trial data for approved immune checkpoint inhibitors and antibody-drug conjugates, and their implications in the curren...

Myasthenia Gravis: A Rare Neurologic Complication of Immune Checkpoint Inhibitor Therapy

Yelena Shames, MS, ACNP-BC, CNRN, CTNL, Mimma Errante, MS, ANP-C, OCN®, and Nana Prempeh Keteku, MS, ANP-BC

Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction, which is characterized by the production of autoimmune antibodies to acetylcholine or muscle-specific kinase receptors, causing an error in transmission of...

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...

Immune Checkpoint Inhibitors: Common Questions About Uncommon Adverse Events

Presented by Lisa Kottschade, APRN, MSN, CNP

At JADPRO Live Virtual 2020, Lisa Kottschade, APRN, MSN, CNP, highlighted considerations for advanced practitioners on the recognition and monitoring of rare and life-threatening immune-related adverse events (irAEs), as well as strategi...

An Evaluation of the Use of Corticosteroids for the Management of Immune-Mediated Adverse Events in Cancer Patients Treated With Immune Checkpoint Inhibitors

Adrian Tsui,(1) PharmD, Lindsay Edmondson,(2) PharmD, BCOP, Justin Julius,(3) PharmD

Immune checkpoint inhibitors (ICIs) have gained prominence for the treatment of a variety of malignancies. However, they are associated with the development of immune-mediated adverse events (IMAEs). Appropriate management of IMAEs and s...

Can You Diagnose the Cause of This Patient’s Diarrhea?

Allison Trail, PA-C

This article will review the case of a 53-year-old female with a diagnosis of metastatic esophageal cancer receiving treatment on a clinical trial protocol combining chemotherapy/immunotherapy with FOLFOX and nivolumab, who presents to t...

The Role of Advanced Practice Providers and Telemedicine in Reinventing Care: The Transition of a CAR T-Cell Transplantation Program to the Outpatient Setting

Kiersten LeBar,(1) DNP, MMHC, APRN, CPNP-AC, Sarah Murawski,(2) MPAS, PA-C, Sherlyn Umayam,(2) MSN, AGACNP-BC, AOCNP®, and Virginia Quinn,(2) MSN, AGACNP-BC

As the health-care industry continues to be pushed to find new, innovative ways to deliver quality care with an emphasis on enhancing quality of life, the use of advanced practice providers and telemedicine technology are two promising d...

Pseudoprogression and Immunotherapy Phenomena

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC, and Donna Lee Gerber, CNS

Traditionally, treatment responses to chemotherapy had been based on Response Evaluation Criteria in Solid Tumours (RECIST) criteria evaluating tumor shrinkage, stabilization of disease, growth, or development of new metastatic lesions. ...

Immune Checkpoint Inhibitor–Based Therapy as a Backbone in Cancer Treatment

Presented by Krista M. Rubin,(1) MS, FNP-BC, and Anthony J. Olszanski,(2) MD, RPh

At JADPRO Live 2019, Krista M. Rubin, MS, FNP-BC, and Anthony J. Olszanski, MD, RPh, reviewed the basic concepts of immunotherapy and the current treatment landscape, and discussed emerging data for immune checkpoint inhibitor–based comb...

Adoptive Cell Therapies: Keeping Pace With New and Emerging Advances

Presented by Patricia Mangan, RN, MSN, CRNP, and Edward Stadtmauer, MD

At JADPRO Live 2019, Patricia Mangan, RN, MSN, CRNP, and Edward Stadtmauer, MD, discussed the emerging world of chimeric antigen receptor (CAR) T-cell therapy, including the CAR T-cell process, approved indications and studies in hematol...

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...

The Role of Advanced Practitioners in Optimizing Clinical Management and Support of Patients With Cytokine Release Syndrome From CAR T-Cell Therapy

Sherry Adkins, MSN, ANP-C

CAR T-cell therapy is rapidly emerging as a promising treatment for many hematologic malignancies. However, CAR T cells can be associated with unique toxicities, including cytokine release syndrome (CRS), which can be severe or fatal if ...

Axicabtagene Ciloleucel: The First FDA-Approved CAR T-Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma

Amber C. King, PharmD, BCOP, and Jennifer S. Orozco, PharmD

Axicabtagene ciloleucel (axi-cel) is an anti-CD19 CAR T-cell therapy that has demonstrated efficacy in relapsed and refractory diffuse large B-cell lymphoma (DLBCL) patients who have had suboptimal responses to conventional therapies. Th...

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...

CAR T-Cell Therapy and the Pharmacology of Managing Cytokine Release Syndrome

Presented by Jae Park, MD, and Amber C. King, PharmD, BCOP

Jae Park, MD, and Amber C. King, PharmD, BCOP, shared background and clinical information regarding CAR T-cell therapy in acute lymphoblastic leukemia and large-cell lymphoma, as well as strategies to mitigate cytokine release syndrome a...

Tisagenlecleucel: The First CAR on the Highway to Remission for Acute Lymphoblastic Leukemia

Craig W. Freyer, PharmD, BCOP

Abstract Tisagenlecleucel is a first-in-class chimeric antigen receptor (CAR) T-cell therapy approved by the US Food and Drug Administration in 2017 for relapsed/refractory (RR) acute lymphoblastic leukemia (ALL) in patients up to 25 ye...

CAR T-Cell Therapy: On the Verge of Breakthrough in Many Hematologic Malignancies

There have been promising results from clinical trials on the efficacy of engineering patients' immune cells to treat their cancers. CAR T-cell therapy also has unique toxicities advanced practitioners should be aware of.

Clinical Management of Pneumonitis in Patients Receiving Anti–PD-1/PD-L1 Therapy

Case Study A 48-year-old gentleman with metastatic melanoma currently receiving the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor, ipilimumab (Yervoy), and the programmed cell death protein 1 (PD-1) inhibitor, nivolumab...

Managing Side Effects of Cancer Patients Treated With Immunotherapy

Immunotherapy has proven activity in several types of cancer; however, the mechanisms of action of immunotherapy can cause several different immune-related toxicities. Advanced practitioners are in a unique position to recognize the timi...

Immunotherapy Through the Years

Advances in the Use of Immunotherapy in Oncology

Innovations in cancer immunotherapy have created new options for patients and avenues for clinicians to practice precision medicine.

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...

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...

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...

Immunotherapy and the Treatment of Non–Small Cell Lung Cancer