Current Issue

VOL 11 NO 7 • SEP/OCT 2020

This issue’s cover illustration depicts pseudoprogression. The yellow represents ipilimumab and nivolumab, and the graph's lines depict hyperprogression, pseudoprogression, partial response, and complete response. Artwork by Alexandra Webber Baker © 2020, DNA Illustrations, Inc., Asheville, North Carolina.


The Changing Landscape of Healthcare and Continuing Education

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

I am sure that many of you can agree that summer this year felt different. Few social gatherings took place, if at all. In most cities, youth sports and summer activities such as baseball and swimming were canceled. Despite these disruptions from the norm, the days of summer seemed to fly by as c...

Research and Scholarship

Revisiting Infectious Complications Following Total Parenteral Nutrition Use During Hematopoietic Stem Cell Transplantation

Halina Rubin,(1) RPh, Jayesh Mehta,(1,2) MD, Jessica L. Fong,(1) PharmD, Deborah Greenberg,(1) PharmD, Solomiya Gruschak,(1,2) BS, and Steven Trifilio,(1,2) RPh

Severe gastrointestinal complications develop frequently during hematopoietic stem cell transplantation (HSCT). Chemotherapy-induced nausea and vomiting (CINV), pain, dysgeusia, fatigue, mucositis, and loss of appetite cause pain and discomfort, and frequently impair oral nutrition. Total parente...

Research and Scholarship

Utilizing a Palliative Care Screening Tool in Patients With Glioblastoma

Jung Young Kim,(1) DNP, APRN, ANP, Katherine B. Peters,(1) MD, PhD, FAAN, James E. Herndon II,(2) PhD, and Mary Lou Affronti,(1) DNP, RN, MHSc, ANP

High-grade gliomas, including glioblastoma (World Health Organization [WHO] grade IV), are the most common primary malignant central nervous tumors (Ostrom et al., 2017). Median overall survival of glioblastoma is 12 to 15 months (Alcedo-Guardia, Labat, Blas-Boria, & Vivas-Mejia, 2016). Durin...

Review Article

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 (PDAC) is a highly aggressive disease. According to the SEER database of the National Cancer Institute, it had a 5-year relative survival rate of 10% from 2010 to 2016. The prognosis of PDAC remains dismal, with a disappointing response to cytotoxic chemoradiother...

Grand Rounds

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®

CASE STUDY 1: Hazel Hazel (Figure 1) was initially diagnosed with breast cancer at age 65. After completing 5 years of adjuvant therapy with letrozole, Hazel considered herself a cancer survivor. She and her husband had always had an active social life, and Hazel went for daily walks with a grou...

Grand Rounds

Pseudoprogression and Immunotherapy Phenomena

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

Case Study Patricia is a Caucasian 48-year-old female who loves outdoor activities and has a history of numerous severe sunburns. Patricia did not use any type of sunscreen. During Patricia’s annual physical examination with her primary physician, a dark pigmented area on her shoulder that had ir...

Translating Research Into Practice

Clinical Trial Design and Drug Approval in Oncology: A Primer for the Advanced Practitioner in Oncology

Sandra E. Kurtin, PhD, ANP-C, AOCN®, and Rashida Taher, MPH, PA-C

Translating research into clinical practice is a challenging and valuable skill for the advanced practitioner (AP) in oncology. Recent analysis of 585 trials registered in the National Cancer Institute Clinical Trials database showed that 29% remained unpublished within 5 years of completion of t...

Practice Matters

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

Cellular therapy is a growing field of cancer treatment (Lamprecht & Dansereau, 2019). Chimeric antigen receptor (CAR) T-cell therapy is perhaps the most notable and promising of these cellular therapies. CAR T-cell therapy utilizes a patient’s own immune T cells to target antigen(s) in an ef...

Prescriber's Corner

Alpelisib: A Novel Therapy for Patients With PIK3CA-Mutated Metastatic Breast Cancer

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

Breast cancer is the most common cancer diagnosed in women in the United States. 1 in 8 women will develop invasive breast cancer in her lifetime. It is expected that in 2019, over 268,000 women will be diagnosed with invasive breast cancer in the United States alone (National Cancer Institute, 2...

Diagnostic Snapshot

Atypical Radiculopathy in an Oncology Patient

Mark Davis, PA-C

History Mr. OH is a 73-year-old male who presented with a nonproductive cough for 1 month and an unexplained 20-pound weight loss. He presented his symptoms to his internist who then ordered a CT scan of the chest. The scan revealed three lung nodules: a 3.2 × 1.7 cm nodule in the right upper lob...

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