“A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it’s just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to lung cancer treatments.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episode: Episode 359: Lung Cancer Screening, Early Detection, and Disparities
• ONS Voice articles:
• Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship
• Oncology Drug Reference Sheet: Amivantamab-Vmjw
• Oncology Drug Reference Sheet: Cisplatin
• Oncology Drug Reference Sheet: Lazertinib
• Oncology Drug Reference Sheet: Nivolumab and Hyaluronidase-Nvhy
• Oncology Drug Reference Sheet: Fam-Trastuzumab Deruxtecan-Nxki
• Optimize Your Testing Strategy and Improve Patient Outcomes With NeoGenomics’ Neo Comprehensive™–Solid Tumor Assay
• Clinical Journal of Oncology Nursing article: Oncogenic-Directed Therapy for Advanced Non-Small Cell Lung Cancer: Implications for the Advanced Practice Nurse
• ONS Biomarker Database
• ONS video: What is the role of the KRAS biomarker in NSCLC?
• Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool
• ONS Huddle Cards:
• Checkpoint inhibitors
• External beam radiation
• Monoclonal antibodies
• Proton therapy

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“Unfortunately, because lung cancer is pretty aggressive, we’ll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they’re locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that’s stage I and II, where we can do surgical approaches.” TS 2:53

“The majority of radiation that you’re going to see is for patients with stage III disease that’s inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51

“Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there’s good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00

“It’s important for nurses to know that there’s a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It’s good that the patients understand that there’s a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05

“The signaling and that binding of the MET and the HGF help, in a downstream way, lead to cell proliferation, cell motility, survival, angiogenesis, and also invasion—so all of those key cancer hallmarks. And because of it being on an epithelial cell, it’s a really good marker because it’s found in many, many different types of cancers, so it makes it what we call kind of a nice actionable mutation,” ONS member Marianne Davies, DNP, ACNP, AOCNP®, FAAN, senior oncology nurse practitioner at Yale Comprehensive Cancer Center in New Haven, CT, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the MET inhibitor drug class.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to MET inhibitors.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
• ONS Voice articles:
• Oncology Drug Reference Sheet: Amivantamab-Vmjw
• Oncology Drug Reference Sheet: Cabozantinib
• Oncology Drug Reference Sheet: Capmatinib
• Oncology Drug Reference Sheet: Tepotinib
• Predictive and Diagnostic Biomarkers: Identifying Variants Helps Providers Tailor Cancer Surveillance Plans and Treatment Selection
• ONS books:
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Safe Handling of Hazardous Drugs (fourth edition)
• Telephone Triage for Oncology Nurses (third edition)
• ONS courses: Safe Handling Basics
• ONS Biomarker Database
• ONS Huddle Cards:
• Monoclonal Antibodies
• Targeted Therapy
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Anticancer Medication Toolkit
• ONS and NCODA Oral Anticancer Medication Compass
• Oral Chemotherapy Education Sheets
• IV Chemotherapy Education Sheets
• Drugs@FDA

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“The MET receptor was actually identified back in 1984. And it was actually identified as an oncogene in osteosarcoma. And so basically what that MET receptor does—it’s a tyrosine kinase pathway, and the ligand that it attaches to is something called HGF/SF. That’s hepatocyte growth factor/scatter factor. And so this MET pathway tyrosine kinase pathway is really important in tumor cell growth and migration. And it’s expressed specifically on epithelial cells, so that’s going to really help us in identifying how it can be a pathway for cancer treatments.” TS 1:35

“But in the particular classes, there kind of are some unique things that are with these MET inhibitors. For example, crizotinib, we found early on, causes some vision changes. Patients would report things like floaters or a little bit of blurry vision. For the capmatinib, things like elevation of amylase and lipase, fluid retention and bloating, and hypersensitivity reactions and photosensitivity.” TS 7:36

“Other things to teach for the TKI is the self-management strategies in terms of nausea management and dietary changes for the risk of peripheral edema. Having them do things like maybe doing daily weights, or at least weights every other day, and sometimes doing limb measurements so it can help us really quantify the amount of fluid retention they have. And then from a nursing perspective, meeting with these patients, is to do really good skin inspection. When people have peripheral edema, they’re at risk for skin breakdown, and that can lead obviously to infection.” TS 16:06

“The biggest [misconception] is that people assume that all MET mutations are going to be equally responsive to the same targeted therapies, that all of the abnormalities are the same and react the same, and they really don’t. We’re really diving down and carving that pie thinner and thinner in terms of each individual MET abnormality, in terms of what drugs responds it to and what that means for patient outcomes and prognosis.” TS 25:21

“We spent time today discussing all the ways that owners can have a positive impact on career growth, whether you’re a bedside nurse or just in teaching, research, hospital leadership. More than career growth, I see ONS as kind of a barrier to burnout and a catalyst for professional self-care. I think that no matter what aspect of oncology care you’re involved in, it is a difficult and complex specialty. And I think with that can come a lot of challenges and tough days, and ONS brings a sense of community to that and, specifically, a community that is pushing cancer care forward,” ONS member Amy Kaiser, MSN, CPNP-PC, told Nick Escobedo, DNP, RN, OCN®, NE-BC, member of the ONS 50th anniversary committee, during a conversation about the benefits of ONS membership. Escobedo spoke with Kaiser, who joined ONS as a student, and Susan Groenwald, PhD, RN, ANEF, FAAN, a charter ONS member, about how ONS membership and resources have helped them grow in their careers.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD. 
• ONS Podcast™ episodes:
  • 50th anniversary series
  • Episode 331: DNP and PhD Collaboration Strategies to Help Advance Oncology Care
  • Episode 327: Journey of a Student Nurse: Choosing Oncology Nursing and the Value of a Professional Home
  • Episode 160: Build Innovative Staff Education Tools and Resources
• ONS Voice articles:
  • Your ONS Membership Offers You Benefits in Other Organizations, Too
  • Co-Creation Modernizes ONS Chapters to Meet Member Needs
• ONS book: Cancer Basics (third edition)
• ONS course: ONS Cancer Basics™
• Clinical Journal of Oncology Nursing article: Professional Organization Membership: The Benefits of Increasing Nursing Participation
• ONS membership
• ONS chapters
• ONS Communities
• Connie Henke Yarbro Oncology Nursing History Center

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

Groenwald: “ONS was groundbreaking in so many areas. The area that sticks out to me was, I was the board liaison to the standards committee. And so, the development of oncology nursing standards, it was a hallmark and critical to the field and to me and my practice, as well as education. It was very exciting time.” TS 4:18

Kaiser: “I think that my very first introduction to cancer care came from the Cancer Basics course. I think I feel fortunate that I probably was the recipient of a lot of the efforts of Susan, who has pioneered so many of these different oncology resources. I had the benefit of being at school during a time where there were a ton of resources available through ONS.” TS 5:38

Groenwald: “Having attended the meetings and getting involved in some of the committees is where I met people and worked with people. And that became, for me, very vital for doing a book, where it was a contributed book, an edited book [Cancer Nursing: Principles and Practice], so we had lots of different chapters and contributors, but I met them all through ONS. And how we communicated was via the old-fashioned mail and telephone. I didn’t even have a computer. We typed the whole manuscript, thousands and thousands of pages, the first couple editions.” TS 12:25

Kaiser: “What’s so wonderful about going to [Congress] is everybody there is looking to move oncology nursing forward and meet people and connect and network. And it's this, you know, magical space of people who are meeting and sharing shared experiences, and I got to feel all of that prior to even being an oncology nurse. And I went home from that first conference, immediately discussed with my manager that I wanted to move to the oncology floor, and I did. But it was meeting all of those people and hearing about those career paths that did that for me.” TS 16:42

Kaiser: “I think people who are involved with ONS, I found, are also very, very willing to mentor. I was very fortunate as I was speaking to these people, not even being an oncology nurse, that they were so welcoming and wanted to welcome me into the specialty and wanted to show me how to get involved. So I think it's just taking that very first step of talking to somebody or going to that local chapter meeting, and then the rest of it becomes a lot easier.” TS 19:29

Groenwald: “One thing Amy mentioned that I think is important is that new nurses have so many opportunities. I think it’s scary to put forth an abstract to speak at the conference. It’s scary, but it's such a great opportunity for anybody at any level in their career. If they have something of interest to share, it’s such a great place. I feel like it launched my career in terms of being able to speak in front of people and think critically about things and put together some projects. This all came from my work with ONS.” TS 20:51

“Everyone’s brain is extremely heterogenic, so it’s different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They’re highly aggressive biologically. It’s a small area in a hard shell. So trying to get through the blood–brain barrier is different. There’s a lot of areas of hypoxia in the brain. There’s a lot of pressure there. The microbiology is very different—it’s a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 25, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to brain malignancies and their diagnosis and treatment.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Episode 235: Self-Advocacy Skills for Patients
• Episode 166: Cognitive Behavioral Interventions Help Patients With a Spectrum of Cancer Symptoms
• ONS Voice articles:
• Glioblastoma Diagnosis, Treatment, Side Effect Management, and Survivorship Recommendations
• Blocking Fatty Acid Storage May Induce Glioblastoma Apoptosis
• Brain Tumor Navigator Role Bridges the Intersection of Cancer and Neuroscience
• Researchers Tie More Cancers, Mortality to NF1 Disorders
• Larotrectinib and Other Tumor-Agnostic Targeted Therapies Are Leading Cancer Care Into the Next Frontier
• McCain Announcement Sheds Light on Nurses’ Role in Advance Care Planning
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• Clinical Journal of Oncology Nursing articles:
• Implementing a Standardized Educational Tool for Patients With Brain Tumors Undergoing Concurrent Temozolomide and Radiation Therapy
• Exercise Intervention: A Pilot Study to Assess the Feasibility and Impact on Cancer-Related Fatigue and Quality of Life Among Patients With High-Grade Glioma
• Society for Neuro-Oncology
• Musella Foundation
• End Brain Cancer Initiative
• Brain Tumor Network
• American Brain Tumor Association
• Glioblastoma Research Organization
• Brain Tumor Funders’ Collaborative
• Optune Gio® website
• Nurse.org article: Mysterious Brain Tumor Cluster Grows: Another Nurse Diagnosed at Newton-Wellesley
• Lori Cappello’s contact information: [email protected]

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“A glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17

“Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?’ But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50

“The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45

“They lose so much of their independence, especially if they don’t have a caregiver or help. That is huge. Medication management at home, to making sure that they’re taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don’t think about.” TS 17:11

“I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there’s a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17

“So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08

“With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,’ if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39

“It is not one of the better cancers to have, but it doesn’t immediately mean it’s a death sentence, and we shouldn’t treat them like they’re dying. We shouldn’t take away their ability to live just because they were diagnosed with it. We shouldn’t take away hope.” TS 25:35

“I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There’s just not enough available for it.” TS 26:59

Episode 359: Lung Cancer Screening, Early Detection, and Disparities

“I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don’t want to do it.’ And I said, ‘Do you remind them that lung cancer is curable?’ Because everybody thinks it is a death sentence. But when you’re talking about screening a patient, I think it’s really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,’” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 18, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to lung cancer screening.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications
• Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion
• Episode 247: Tobacco Treatment for Patients With Cancer
• ONS Voice articles:
• Lung Cancer Screening and Early Detection Drastically Improves Survival Rates
• Pack-Year History Is a Biased and Inadequate Criterion for Lung Cancer Screening Eligibility, Researchers Say
• CMS Expands Eligibility Criteria for Lung Cancer Screening With Low-Dose Computed Tomography
• Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship
• Clinical Journal of Oncology Nursing articles:
• Nurse-Led Tobacco Cessation for Veterans Using Motivational Interviewing in a Lung Cancer Screening Program
• Identifying Primary Care Patients at High Risk for Lung Cancer: A Quality Improvement Study
• Oncology Nursing Forum article: Patient–Provider Discussion About Lung Cancer Screening Is Related to Smoking Quit Attempts in Smokers
• ONS Tobacco, E-Cigarettes, and Vaping Learning Library
• American Cancer Society Lung Cancer Screening Guidelines
• American Lung Association lung cancer resources

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32

“If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that’s why once patients have quit more than 15 years, they’re actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they’re no longer eligible for screening.” TS 5:17

“One of the strategies that they’ve used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it’s beneficial.” TS 13:16

“Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52

“I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I’d love to get screened for lung cancer, but I just can’t find time to fit it into my schedule, and my job won’t let me take off.’ These are all things that we don’t always think about if you have the luxury of just taking the day off.” TS 20:01

“It’s been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn’t figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it’s specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the KRAS inhibitor drug class.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 11, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to KRAS inhibitors used for cancer treatment.

Episode Notes 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Cancer Symptom Management Basics series
• Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
• ONS Voice articles:
• First KRAS-Targeted Therapy Receives FDA Approval for Lung Cancer
• Oncology Drug Reference Sheet: Adagrasib
• Oncology Drug Reference Sheet: Sotorasib
• ONS books:
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Safe Handling of Hazardous Drugs (fourth edition)
• ONS course: Safe Handling Basics
• ONS video: What is the role of the KRAS biomarker in NSCLC?
• ONS Targeted Therapy Huddle Card
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Anticancer Medication Toolkit
• ONS and NCODA Oral Anticancer Medication Compass
• Oral Chemotherapy Education Sheets
• Lumakras® (sotorasib) manufacturer website
• Krazati® (adagrasib) manufacturer website
• UpToDate Lexidrug (formerly Lexicomp)

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“If we look at specifically non-small cell lung cancer, this KRAS mutation is one of the most frequently detected cancer drivers or driver mutations. It’s thought that about a quarter of cases of non-small cell lung cancer have this KRAS mutation, and it’s usually a specific amino acid substitution that we see in non-small cell lung cancer, so what’s known as KRAS G12C mutation.” TS 2:31

“Both of these agents, sotorasib and adagrasib, have the same mechanism of action. They bind to a pocket, very specifically on the KRAS G12C protein, and they lock it in an inactive state so that it can’t cause that downstream uncontrolled signaling to happen. So they’re kind of shutting down the signaling, and therefore you don’t get that uncontrolled cell growth and proliferation.” TS 4:27

“Another big difference to point out, and one that is often used in clinical practice to differentiate when to use these agents, is specifically adagrasib is known to have activity in patients with metastatic non-small cell lung cancer that have active brain metastases. In the clinical trial, they included patients with active brain metastases, and they found that this drug has great [central nervous system] penetration. And so it may be considered the agent of choice in patients with brain metastases.” TS 7:19

“Other considerations—I think one of the big ones—is that there are a lot of drug interactions. Just specifically calling one out that I think is pretty impactful, is sotorasib has an interaction with acid-suppressing medications. So there is the recommendation to avoid [proton pump inhibitors] and H2 antagonists in patients receiving sotorasib. They can take antacids, but you would need to space those out from their dose of sotorasib.” TS 14:14

“This needs to be a collaborative endeavor to make sure these patients are monitored appropriately. We are putting a lot of responsibility on the patients with all of this. So, again, completely administered generally in the home setting, a lot of monitoring, a lot of adverse effects, need for reporting and management—so there’s a lot happening here. And it takes a team to accomplish this and to do it right. And I firmly believe that this is often a collaborative effort between our pharmacy and oncology nursing teams to make this happen. Working together to ensure outreach to patients—I think that patients are often more successful with these medications with early identification of toxicities when we’re doing scheduled outreach.” TS 19:44

“There have been many changes since the ’70s that have shaped the nurse’s role in administering chemo, and in supporting patients. The major change early on was the transition from that of nurses mixing chemo to that of pharmacists. Regulatory agencies like NIOSH and OSHA defined chemotherapy as hazardous drugs, and professional organizations became involved, leading to the publication of the joint ASCO and ONS Standards of Safe Handling,” ONS member Scarlott Mueller, MPH, RN, FAAN, secretary of the American Cancer Society Cancer Action Network Board and member of the Oncology Nursing Foundation Capital Campaign Cabinet, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, ONS member and chair of the ONS 50th Anniversary Committee during a conversation about the evolution of chemotherapy treatment. Along with Mueller, Burbage spoke with John Hillson, DNP, NP, Mary Anderson, BSN, RN, OCN®, and Kathleen Shannon-Dorcy, PhD, RN, FAAN, about the changes in radiation, oral chemotherapy, and cellular therapy treatments they have witnessed during their careers.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD.
• ONS Podcast™ episodes:
  • 50th anniversary series
  • Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
  • Episode 59: Blood and Marrow Transplant Nursing
  • Episode 16: Navigating the Challenges of Oral Chemotherapy
• ONS Voice article:Safe Handling—We’ve Come a Long Way, Baby!
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition)
  • Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
  • Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses:
  • ONS Hematopoietic Stem Cell Transplantation™
  • ONS/ONCC® Chemotherapy Immunotherapy Certificate™
  • ONS/ONCC® Radiation Therapy Certificate™
  • Safe Handling Basics
• Oral Anticancer Medication Toolkit
• Oral Anticancer Medication Care Compass
• Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers:
  • IV Cancer Treatment Education Sheets
  • Oral Chemotherapy Education Sheets
• Connie Henke Yarbro Oncology Nursing History Center

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

Hillson: “I remember as a new grad, from back in ’98, walking up to the oncology floor. We had patients with pink labels on the chart and that was the radiation oncology service. I hadn’t heard of such a thing before. … I’d gone through nursing school and hospital orientation and unit orientation without ever hearing of these therapies. At the time, both the management and the union had no interest in specialist nurses, and the really weren’t any books that were targeting the role. And it was very isolating and frightening. I was very glad to find ONS when I moved to the U.S. Right now, the Oncology Nursing Society Manual for Radiation Oncology, Nursing Practice, and Education, it’s in its fifth edition and a sixth is underway. There’s nothing else like it. Most books are very much geared towards other professions.” TS 5:34

Mueller: “We mixed our chemo in a very small medication room on the unit, under a horizontal laminar flow hood, which we later discovered should have been a vertical laminar flow hood. Initially, we did not use any personal protective equipment. I remember mixing drugs like bleomycin and getting a little spray that from the vial onto my face. And to this day, I still have a few facial blemishes from that.” TS 14:28

Anderson: “As the increasing number of these actionable mutations continue to grow, so will the number of oral anticancer medications that patients are going to be taking. And we are already seeing that there's multiple combination regimens and complex schedules that the patients have to take. So this role the oral oncolytic nurse and the nursing role, like you said, it cannot be owned by one individual or discipline. So it’s not a pharmacist; the pharmacies aren’t owning this. The nurses are not owning this. It takes a village.” TS 32:12

Shannon-Dorcy: Then as immunotherapy comes into the picture, we start to learn about [cytokine release syndrome]. All of a sudden, we had no concept that this was a deadly consequence. ONS was on the front lines, convening people across the country together so we could speak to the investigative work with science and find ways that we could intervene, how we can look for signs of it early on with handwriting testing.” TS 39:58

“And so you have different kinds of hazards with the drugs that you’re using. That means that in the past, when a lot of oncology drugs, antineoplastic drugs used to treat cancer would have been added, you may see that a lot of oncology drugs either weren’t added or they’re added in a different place on the list than they were in the past. That’s due to some of the restructuring of the list we’ll probably talk about later,” Jerald L. Ovesen, PhD, pharmacologist at the National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the latest update to the NIOSH list of hazardous drugs. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Episode Notes  

• NCPD contact hours are not available for this episode. 
• ONS Podcast™ episodes:
  • Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs 

  • Episode 142: The How-To of Home Infusions

  • Episode 68: Empowering Healthcare Workers to Handle Hazardous Drugs
  • Episode 53: Home Care Nursing for Patients With Cancer
• ONS Voice articles:
  • Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE 
  • NIOSH Releases Its 2024 List of Hazardous Drugs 
  • No Place Like It: Home Care for Patients With Cancer 
  • What Is ONS’s Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive? 
  • What You Wear Matters When It Comes to Safety 
• ONS book: Safe Handling of Hazardous Drugs (Fourth Edition) 
• ONS course: Safe Handling Basics 
• Clinical Journal of Oncology Nursing article: Safe Management of Chemotherapy in the Home 

• ONS Learning Library: Safe Handling of Hazardous Drugs 

• ONS Position Statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs 
• National Institute for Occupational Safety and Health article: Managing Hazardous Drug Exposures: Information for Healthcare Settings 
• NIOSH List of Hazardous Drugs in Healthcare Settings, 2024 

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. 

To provide feedback or otherwise reach ONS about the podcast, email [email protected]. 

Highlights From This Episode 

“So we look for a carcinogenic hazard. So does this molecule, does this chemical, this drug, have the ability to increase the risk of cancer? A lot of the time that will also tie with genotoxic hazards, but not always. There are some drugs on the list that are carcinogenic through other mechanisms. Sometimes carcinogenicity can be related to hormone signals, can lead to increased risk of cancer. There’s some nuance there, but is it a carcinogenic hazard? That can get it onto the list. Is it a developmental and reproductive hazard?” TS 10:48 

“NIOSH can’t say what’s right for every situation, but some organizations have suggested further precautions such as temporary alternative duty for workers who are pregnant or are looking to become pregnant. NIOSH can’t say what’s best for any given facility, but other organizations have given some good suggestions you may want to look into.” TS 13:18 

“The list doesn’t really rank hazard. I know a lot of people have kind of treated it that way a lot of times. We don’t say that something is less hazardous if it’s only a developmental or reproductive hazard, because if you’re trying to have a child, then that’s an important hazard to you. And we don’t necessarily say something that’s carcinogenic is more hazardous.” TS 14:34 

“Some standard setting organizations have set standards for handling. Really in the oncology setting, particularly oncology pharmacy setting, it’s really changed how some of the handling happens there because some of the standards come out of the pharmacy world. And what’s happened there is some drugs that are oncology drugs, they might have been on table one before just because they were used in the treatment of cancer. They were antineoplastics, so they were on table one. Now, because they’re not identified as a potential carcinogen and they don’t have manufactured special handling information, they are now on table two.” TS 23:39 

“Occasionally, if a drug comes out and has manufacturer special handling information, we’ll go ahead and add it to the list. And since we won’t add it into the publication, we typically have a table on that page that puts that there. If a drug is reevaluated and we find that the hazard is not as bad as expected or it’s not a hazard, actually, and we can remove it from the list; sometimes we get new information and that happens.” TS 30:30 

“I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I’ve encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about hedgehog pathway inhibitors. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to hedgehog pathway inhibitors used for cancer treatment. 

Episode Notes  

• Complete this evaluation for free NCPD. 
• ONS Podcast™ Pharmacology 101 series 
• ONS Voice articles:
  • An Oncology Nurse’s Guide to Targeted Therapy
  • FDA Approves Glasdegib for AML in Adults Aged 75 or Older or Who Have Comorbidities
  • Oncology Drug Reference Sheet: Glasdegib
  • Understanding Precision Medicine Therapeutics
• ONS courses:
  • Genomic Foundations for Precision Oncology
  • ONS Cancer Biology™  
• ONS Guidelines™ and Symptom Interventions: 
  • Diarrhea
  • Fatigue
• ONS Huddle Card: Targeted Therapy
• ONS Learning Libraries:
  • Oral Anticancer Medication
  • Pain Management 
• Oral Chemotherapy Education Sheets
• American Association for Cancer Research article: Hedgehog Pathway Inhibitors: A New Therapeutic Class for the Treatment of Acute Myeloid Leukemia
• American Journal of Clinical Dermatology article: Evaluation of the Tolerability of Hedgehog Pathway Inhibitors in the Treatment of Advanced Basal Cell Carcinoma: A Narrative Review of Treatment Strategies
• Cureas article: Hedgehog Pathway Inhibitors: Clinical Implications and Resistance in the Treatment of Basal Cell Carcinoma
• International Journal of Molecular Sciences article: Hedgehog Pathway Inhibitors as Targeted Cancer Therapy and Strategies to Overcome Drug Resistance 

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. 

To provide feedback or otherwise reach ONS about the podcast, email [email protected]. 

Highlights From This Episode 

“Many patients unfortunately will have side effects with this class. I mean—and I know that’s not controversial—but you actually find callouts in some of the kind of the national consensus guidelines. These treatments might not be tolerable for a decent number of patients. Some of these side effects can certainly reduce quality of life. Again, nothing that controversial here when we say it out loud, but just the frequency with which it occurs can make it quite difficult for some patients.” TS 9:13 

“Certainly, based on what we said before, I think one of the easiest things to do for patients starting this class is to just make sure that they have really classical supportive medicines like antidiarrheals and antiemetics before they start treatment. Diarrhea, nausea occurred in about 20%–40% of patients across trials. So certainly patients should be aware of that risk. Again, not a controversial side effect, but it’s just simple things we can do to make sure that our patients are quick to start treatment is to make sure that they have these medicines and they’re educated on how to use them.” TS 11:21 

“I think patients need to be aware that side effects, as I had mentioned before, can be especially frequent with this class. So for a patient, they need to be aware that communicating your needs to your oncology team is really crucial to their own ability to use these treatments with minimal interruptions.” TS 14:45 

“I think that regardless of whoever is following up with our patients, though, as our arsenal of oral anticancer therapies does continue to expand, both nurses and pharmacists need to have specialized knowledge of these agents to be successful in their patient care roles.” TS 18:28 

“When there are clear recommendations for reproductive health, as I summarized before with these agents, I obviously think we need to be aware of them and not just defer to these generic recommendations. Because if you just defer to, ‘Well, use barrier contraception and then for a week after your last dose,’ you know, ‘Okay, it’s not true with these agents.’” TS 24:37 

“You can give someone a survivorship care plan, but just giving them doesn’t mean that it’s going to happen. Maybe there’s no information about family history. Or maybe there’s information and there’s quite a bit of family history, but there’s nothing that says, ‘Oh, they were ever had genetic testing,’ or ‘Oh, they were ever referred.’ So the intent is so good because it’s to really take that time out when they’re through with active treatment and, you know, try to help give the patient some guidance as to what to expect down the line,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer survivorship.  

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to breast cancer survivorship. 

Episode Notes  

• Complete this evaluation for free NCPD.  
• Previous ONS Podcast™ site-specific episodes:
  • Episode 350: Breast Cancer Treatment Considerations for Nurses 
  • Episode 348: Breast Cancer Diagnostic Considerations for Nurses 
  • Episode 345: Breast Cancer Screening, Detection, and Disparities 
• ONS Voice articles:
  • Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations 
  • Improve Management of Common Symptoms for Breast Cancer Survivors 
  • Nursing Considerations for Breast Cancer Survivorship Care 
  • Sexual Considerations for Patients With Cancer
• ONS books: 
  • Breast Care Certification Review (second edition) 
  • Guide to Breast Care for Oncology Nurses 
• ONS course: Breast Cancer Bundle 
• ONS Learning Libraries: 
  • Breast Cancer 
  • Genomics and Precision Oncology 
  • Nurse Navigation 
  • Oral Anticancer Medication  
  • Survivorship 
• ONS Guidelines™ and Symptom Interventions: 
  • Anxiety 
  • Cognitive Impairment 
  • Depression 
  • Fatigue 
• Clinical Journal of Oncology Nursing article: Survivorship Care: More Than Checking a Box 
• Clinical Journal of Oncology Nursing supplement: Survivorship Care 
• American Cancer Society: 
  • Cancer Treatment and Survivorship Facts and Figures 
  • Survivorship: During and After Treatment 
• Livestrong® Program at the YMCA 
• National Comprehensive Cancer Network 
• National Cancer Institute Breast Cancer—Patient Version   

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. 

To provide feedback or otherwise reach ONS about the podcast, email [email protected]. 

Highlights From This Episode 

“I think the biggest thing is to really communicate is that people are living with breast cancer for a long, long periods of time, and a lot of that with really good quality overall.” TS 4:07  

“As a general rule, they’re going to be seen by the breast surgeon probably every four to six months for a while. After about five years, a lot of times people are ready to say, ‘Okay, annually is okay.’ And eventually they may let that drop off. But it also depends on did they have a mastectomy? Did they have breast conserving surgery? And then if they had reconstruction with an implant, how often do they see the plastic surgeon? Because they need to check integrity of the implant. So those schedules are really individualized.” TS 13:24 

“When you think about long-term effects, I think you need to kind of think about that survivors can have both acute and long-term chronic effects. And a lot of that depends on the specifics of the treatment they had. I think as oncology nurses, we’re used to, ‘We give you this chemotherapy or this agent, and these are the side effects.’” TS 15:36 

“The diet issues are huge. And I think we are slow to refer to the dietician, you know, you can get them a couple of consults and because you’re saying to them, ‘This is really important. We need you to lose weight or we need you to eat more of this.’ Ideally, fruits and vegetables are going to be about half of your plate. And what’s the difference between a whole grain and not, less processed foods, making sure that they’re getting enough protein. And then once again, really kind of making sure that they’re not taking a lot of supplements and extra stuff because we don’t really understand all that fully and it could be harmful.” TS 34:53 

“Breast cancer is a long, long journey, and I think you should never underestimate the real difference that nurses can make. I think they can ask those tough questions. And I think ask the questions that are important to patients that patients may be reluctant to ask. I think giving patients permission to talk about those less-talked-about symptoms and acknowledge that those symptoms are real and that there are some strategies to mitigate those symptoms.” TS 42:28