Solid Tumors

Improving Outcomes for Women With Metastatic HER2-Positive and HER2-Low Breast Cancer

Presented by Stephanie L. Graff,(1,2) MD, FACP, FASCO, Christine McGinn,(1) MSN, APRN, ACNP-BC, and Jeanine R. Showalter,(3) MSN, APRN, FNP-BC, AOCNP®

At JADPRO Live 2023, presenters discussed recent updates to clinical practice in metastatic HER2-positive metastatic breast cancer. During the session, they reviewed review recent FDA approvals, the clinical relevance of HER2-low status,...

Precautions for Patients Taking Tamoxifen or Aromatase Inhibitors

Mary Heery, APRN, AOCNS®, CBCN

Tamoxifen and aromatase inhibitors are widely prescribed therapies for the treatment of breast cancer. Tamoxifen is a selective estrogen receptor modulator that treats hormone-sensitive breast cancers. Research has demonstrated that tamo...

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...

Advancing the Care of Women With HER2-Positive Metastatic Breast Cancer

Presented by Marcie Beasley, FNP-C, AOCNP®, and Brooke Daniel, MD

HER2 is overexpressed and/or amplified in approximately 20% of breast cancers. It is a clinically aggressive subtype; however, the introduction of targeted therapies has greatly improved survival rates. At JADPRO Live 2022, presenters di...

Managing the Patient With Multiple Primary Tumors

Presented by Holly Chitwood, DNP, APRN, FNP, AGACNP, and Tamara Carey, MSN, APRN, FNP

Multiple primaries are defined as more than one synchronous or metachronous cancer in the same individual. They can pose challenges to clinicians, as the goal is to find an anticancer therapy strategy that covers both cancer types withou...

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...

Timely Genetic Testing and Therapy Management in Patients With gBRCA-Mutated Metastatic Breast Cancer Receiving Talazoparib

Ashley Martinez,(1) DNP, APRN, FNP-BC, AOCNP®, CBCN, CPHQ, NEA-BC, Tiffany Jones,(2) MSN, ACNP-BC, Joanne C. Ryan,(3) PhD, RN, Chad M. Barnett,(3) PharmD, BCOP, Elpitha L. Soussou,(3) PharmD, MBA, and Sarah Donahue,(4) MPH, NP, AOCNP®

Talazoparib is a poly(ADP-ribose) polymerase (PARP) inhibitor that has demonstrated strong efficacy with manageable side effects for patients with germline breast cancer susceptibility genes 1 or 2 (gBRCA1/2)-mutated, human epidermal gro...

Breast Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Jacquelyn Lauria, RN, APN, AOCNP® and Rose DiMarco, PharmD, BCPS, BCOP

Jacquelyn Lauria, RN, APN, AOCNP®, of Rutgers Cancer Institute, discusses results from the DESTINY-BREAST04 trial on HER2-low metastatic breast cancer, findings on sacituzumab govitecan in HR-positive, HER2-negative metastatic breast can...

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...

Sacituzumab Govitecan for Treatment of Refractory Triple-Negative Metastatic Breast Cancer

Patrick J. Fleming Jr., PharmD, BCOP, Sylvia Karpio, PharmD candidate, and Nicholas Lombardo, PharmD candidate

Sacituzumab govitecan was initially approved in April 2020 under accelerated approval for the treatment of patients with metastatic triple-negative breast cancer who received at least two prior therapies for metastatic disease. A confirm...

Other Solid Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abby Fuoto, DNP, ANP-BC, AOCNP®, ACHPN and Mee-young Lee, MSN, ANP-BC

Abby Fuoto, DNP, ANP-BC, AOCNP®, ACHPN, of University of Arizona Cancer Center, considers the implications of a novel monoclonal antibody for nasopharyngeal cancer, and Mee-young Lee, MSN, ANP-BC, of Monter Cancer Center, Northwell, disc...

Breast Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Sheeba Cantanelli, MPAS, PA-C

Sheeba Cantanelli, MPAS, PA-C, of UT Southwestern Medical Center, Simmons Comprehensive Cancer Center, discusses results from studies evaluating adjuvant therapy with a PARP inhibitor in BRCA-mutated HER2-negative metastatic breast cance...

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...

Ribociclib and Abemaciclib: CDK4/6 Inhibitors for the Treatment of Hormone Receptor–Positive Metastatic Breast Cancer

Kristina F. Byers, PharmD, BCOP

The treatment landscape of hormone receptor–positive (HR+), human epidermal growth factor receptor 2–negative (HER2–) metastatic breast cancer has been modernized by the identification of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibito...

Development, Implementation, and Patient Perspectives of the Women’s Integrative Sexual Health Program: A Program Designed to Address the Sexual Side Effects of Cancer Treatment

Lori A. Seaborne, MPAS, PA-C, Megan Peterson, DNP, David M. Kushner, MD, Janelle Sobecki, MD, MA, and Joanne K. Rash, MPAS, PA-C

Background: Advanced practitioners (APs) are a growing demographic in survivorship care. One goal of survivorship care is to manage consequences of cancer treatments. Sexual dysfunction from prior therapies can impact quality of life. Ad...

Oncology Advanced Practitioners and Breast Cancer Prevention

Wendy H. Vogel,(1) MSN, FNP, AOCNP®, Haley Pace,(2) MS, CGC, and Matthew Brignola,(3) PharmD

One in eight American women will be diagnosed with breast cancer. Advanced practitioners in oncology can offer risk assessments, counseling, genetic testing, and make both behavioral and pharmacologic recommendations for breast cancer ri...

Optimizing Palbociclib Therapy Across the Age Spectrum: Hypothetical, Illustrative Case Scenarios in HR+, HER2– Metastatic Breast Cancer

Kimberly Podsada,(1) MSN, NP-C, Joanne C. Ryan,(2) PhD, RN, and Kristi Orbaugh,(3) RN, MSN, RNP, AOCN®

Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors in combination with endocrine therapy are a preferred treatment option for premenopausal and postmenopausal women with hormone receptor–positive (HR+), human epidermal growth factor rec...

Alpelisib: A Novel Therapy for Patients With <em>PIK3CA</em>-Mutated Metastatic Breast Cancer

Tori Wilhoit, PharmD, Jeannie M. Patrick, PharmD, BCOP, and Megan B. May, PharmD, BCOP

In the United States, 1 in 8 women will be diagnosed with invasive breast cancer in her lifetime. Breast cancer death rates are higher for women in the United States than any other cancer, followed by lung cancer (National Cancer Institu...

Breast Cancer: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Paula Anastasia,(1) RN, MN, AOCN®, and Wendy H. Vogel,(2) MSN, FNP, AOCNP®

Paula Anastasia, RN, MN, AOCN®, of UCLA Health Medical Center, and Wendy H. Vogel, MSN, FNP, AOCNP®, of Harborside, discuss results from studies evaluating therapies in women with de novo metastatic breast cancer and HER2-positive breast...

A Patient-Centered Approach for the Treatment of Fungating Breast Wounds

Karlyn L. Rupert, MPAS, PA-C, and Andrea J. Fehl, CRNP, AOCNP®

Nearly 2% to 5% of locally advanced breast cancers develop a fungating breast wound (FBW). Fungating breast wounds develop when malignant cells infiltrate the skin and cause breakdown, ulceration, and infection. Although systemic and loc...

Larotrectinib and Entrectinib: TRK Inhibitors for the Treatment of Pediatric and Adult Patients With NTRK Gene Fusion

Danielle B. Dunn, PharmD

Two new targeted agents have been approved for pediatric and adult patients with advanced or metastatic solid tumors with neurotrophic receptor tyrosine kinase (NTRK) gene fusion without an acquired resistance mutation. Larotrectinib and...

Improving Outcomes in HER2-Positive Breast Cancer: Analysis and Application of Evolving Data and Best Practices

Presented by Jame Abraham, MD, and Kelley D. Mayden, MSN, FNP, AOCNP®

Through expert, case-based discussion, Jame Abraham, MD, and Kelley Mayden, MSN, FNP, AOCNP®, presented existing and emerging data for current and investigational therapies for HER2-positive breast cancer and their associated adverse eve...

Hormone Receptor–Positive, HER2-Negative Breast Cancer: Recent Advances and Best Practices

Presented by Lee Schwartzberg, MD, FACP, and Heather Greene, MSN, FNP, AOCNP®

Lee Schwartzberg, MD, FACP, and Heather Greene, MSN, FNP, AOCNP®, reviewed optimal therapy for patients with hormone receptor–positive, HER2-negative breast cancer, as well as the management of adverse events associated with treatment. 

Precautions for Patients Taking Aromatase Inhibitors

Mary Heery,(1) APRN, AOCNS®, CBCN, Stephen Farley,(2) PharmD, BCOP, Rhett Sparkman,(2) PharmD, John Healy, BS, Pharmd, William Eighmy,(3) PharmD, George Zahrah,(2) MD, and Richard Zelkowitz,(1) MD

Aromatase inhibitors are the drug of choice for the treatment of estrogen receptor– or progesterone receptor–positive breast cancer in postmenopausal women. Aromatase is an enzyme that catalyzes the final and rate-limiting step in the bi...

A Tale of Two Sisters: Breast Reconstruction Options for Women With or at High Risk of Breast Cancer

Kathryn Trotter,(1) DNP, CNM, FNP, FAAN, Jennifer K. Plichta,(2) MD, MS, FACS, and Michael Zenn,(3) MD, MBA, FACS

Breast reconstructive surgery has changed significantly over the past decade. The incidence of nipple-sparing procedures and prophylactic mastectomy has also increased significantly as women and their surgeons use shared decision-making ...

Advances in Oral Oncolytic Agents for Breast Cancer and Recommendations for Promoting Adherence

Theresa Wicklin Gillespie, RN, MA, PhD, FAAN

Hormone receptor positivity and early stage diagnosis are generally considered signs of good prognosis in breast cancer. However, breast cancer all too frequently can become resistant to hormone-based therapies, and women can experience ...

Metabolic Syndrome, Exercise, and Cardiovascular Fitness in Breast Cancer Survivors

M. Tish Knobf, PhD, RN, AOCN®, FAAN, and Sangchoon Jeon, PhD

Comorbid illness contributes to poorer cancer outcomes and higher mortality. Metabolic syndrome (MetS) includes a cluster of risk factors that are associated with an increased risk of comorbidities. Routine physical activity represents a...

Dihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen?

Wendy H. Vogel,(1) MSN, FNP, AOCNP®, Ahmed Minhas,(2) MD, and Steven Baumrucker,(1) MD

5-fluorouracil (5-FU) and its prodrug capecitabine are frequently prescribed in oncology. While usually well tolerated, toxicity can be severe, and even life-threatening. A dihydropyrimidine dehydrogenase (DPD) deficiency can cause sever...

Breast Density and Breast Cancer

Pamela Hallquist Viale, RN, MS, CNS, ANP

Treatment of Pregnancy-Associated Breast Cancer

Bernadette Labriola, RN, MSN, FNP-C

Case Study KS is a 33-year-old Caucasian married woman who works full time as an accountant and has one daughter who is 2 years old. She enjoys reading and exercising in her spare time. She initially presented in July 2015 at the age of...

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Breast Cancer

Wendy H. Vogel, MSN, FNP, AOCNP®

Wendy H. Vogel, MSN, FNP, AOCNP®, of Wellmont Cancer Institute discusses results from a study in hormone receptor–positive metastatic breast cancer (MONALEESA-7), two studies in the metastatic HER2-positive setting (SOPHIA and NALA), as ...

Breast Cancer in the Transgender Population

Andrea Fehl,(1) FNP-C, MSN, AOCNP®, Shannon Ferrari,(1) PA-C, MPAS, Zoe Wecht,(1) BS, and Margaret Rosenzweig,(2) PhD, FNP-C, AOCNP®, FAAN

Case Study ES is a 41-year-old transgender male who presented to medical oncology as a referral from surgical oncology for T2N0M0 right breast cancer. At that time, he was receiving weekly testosterone injections intramuscularly at 0.25...

Advances in the Treatment of HER2-Positive Breast Cancer

Presented by Reshma Mahtani, DO, and Lisa Hineman, MS, AOCN®, PHN, ANP-C

Reshma Mahtani, DO, and Lisa Hineman, MS, AOCN®, PHN, ANP-C, reviewed landmark clinical trials of adjuvant therapies for women with HER2–positive breast cancer and emphasized the key role of advanced practitioners in managing adverse eve...

Surgical Implications for Women With Breast Cancer

Presented by Sherry Goldman, MSN, NP, CBCN

At JADPRO Live 2018, Sherry Goldman, MSN, NP, CBCN, delved into different surgical rationales for lumpectomy, mastectomy, and mastectomy with reconstructions. Ms. Goldman also explored the benefits and disadvantages associated with nippl...

Advances in HER2-Positive Breast Cancer: Novel Therapies and Adverse Event Management

Reshma Mahtani, DO, and Lisa Hineman, MS, AOCN®, PHN, ANP-C

Abstract Although breast cancer is a heterogeneous disease, approximately 20% to 25% of patients diagnosed with breast cancer have amplification of the HER2 gene. The FDA approval of trastuzumab for the treatment of HER2-positive (HER2+...

Olaparib: A Novel Therapy for Metastatic Breast Cancer in Patients With a BRCA1/2 Mutation

Sarah E. Caulfield, PharmD, BCOP, Christine C. Davis, PharmD, BCOP, and Kristina F. Byers, PharmD, BCOP

Breast cancer is the most frequently diagnosed cancer in women globally. Genetic mutations can increase the risk of developing breast cancer. Inherited germline mutations in BRCA1 and BRCA2 tumor suppressor genes (gBRCAm) account for 5% ...

Neratinib for the Treatment of Early-Stage HER2-Positive Breast Cancer

Jennifer Miles, PharmD, and Yahsin White, PharmD

Abstract The treatment of breast cancer has been revolutionized by the development of HER2-targeted treatments for patients who are HER2 positive. The HER2 protein is present at high levels in about 30% of breast cancer patients. These ...

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...

Breast Cancer and Body Image Issues

Neratinib for Extended Anti-HER2 Therapy in Early Breast Cancer

Neratinib following the completion of trastuzumab has been shown to reduce the risk of disease recurrence for patients with HER2-positive early breast cancer in whom extended adjuvant therapy seems advisable. In clinical trials, the most...

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...

Precautions for Patients Taking Tamoxifen

Tamoxifen is a lifesaving treatment for millions of breast cancer patients worldwide. Yet taking tamoxifen may be challenging for some patients due to issues of compliance, drug interactions, and surgical considerations. Educating patien...

Li-Fraumeni Syndrome

Breast Implants and Lymphoma: What Is the Risk for Your Patient?

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...

Collaborative Management of Patients With Estrogen Receptor–Positive Breast Cancer

Cyclin-dependent kinase (CDK) inhibitors represent a new form of cytotoxic chemotherapy. Advanced practitioners can read this article to find out about the science behind CDK inhibition, when CDKs are indicated, how to monitor for and ma...

Current and Emerging Therapies for HER2-Positive Women With Metastatic Breast Cancer

Case Study DE, a 31-year-old premenopausal woman with a nonsignificant medical history, noticed a right breast mass after playing basketball in September 2011. She initially attributed the mass to slight trauma, but after 2 weeks, she r...

Understanding Biomarkers in Early-Stage Invasive Breast Cancer: Tools From the ASCO Clinical Guideline

Palbociclib Plus Letrozole for the Treatment of Metastatic Breast Cancer: An Illustrative Case Scenario

Case Study Betty, a 66-year-old white female, was diagnosed with stage IIB, T2N1M0, estrogen receptor/progesterone receptor–positive, HER2-negative breast cancer in 2007. It was detected on screening mammography when she was age 59, and...

Review of the New American Cancer Society Guidelines for Breast Cancer Screening for Women at Average Risk

When Should I Have a Mammogram? Recent Changes in ACS Mammography Guidelines: Implications for Practice

Beyond BRCA: A Pilot Program to Assess and Improve Knowledge of Pharmacogenomic Testing Among Advanced Practitioners in a Breast Cancer Treatment Setting

To provide the best available evidence-based care to their patients, advanced practitioners (APs) must become proficient in genomic competencies and remain informed regarding the availability of pharmacogenomic tests. Databases, such as ...

New Agents for the Management of Advanced HER2-Positive Breast Cancer

Overview of the CLEOPATRA Trial: Implications for Advanced Practitioners