Congress Abstracts 2003

93

THE ROLE OF THE ONCOLOGY NURSE IN IMPLEMENTING NEW TARGETED THERAPIES. Tracy Curley, RN, OCN^®, Anthony Delacruz, RN, OCN^®, BSN, MS, MBA, Susan Reyes, RN, and Michael Morris, MD, Memorial Sloan-Kettering Cancer Center, New York, NY.

The oncology nurse has an essential role as new targeted therapies are introduced. The development of these therapies requires nursing interventions such as patient education, ongoing symptom assessment, and monitoring for prevention and management of adverse effects. Prostate specific membrane antigen is a cell surface glycoprotein expressed on benign and malignant prostate epithelial cells and the neovasculature of non-prostate solid tumors. J591 is a monoclonal antibody that targets the external domain of this antigen and has the potential to specifically target tumor sites while sparing normal tissue. Pre-clinical data indicate that unlabeled J591 induces antibody dependent cellular cytotoxicity (ADCC). The antibody can also be radiolabeled as a vehicle to deliver tumor-directed radiation therapy. There is an ongoing clinical study examining the efficacy of unlabeled antibody for patients with androgen independent prostate cancer, and another trial for patients with non-prostate solid tumors. Antibody is labeled with tracer levels of indium-111 and is used to define dosimetry and drug localization. Nurses are an integral part of a multidisciplinary team comprised of medical oncology, nuclear medicine, radiochemistry, immunology, diagnostic radiology, and medical physics to coordinate care and to ensure the execution of all correlative studies. The oncology nurse educates patients regarding this novel mechanism of the therapy, the unique assays used to assess its activity, and communicates these elements of the trial to the patient. Comprehensive understanding of the rationale for performing ADCC and human anti-human antibodies (HAHA) assays is crucial. The nurse must be aware of the concept of assessing radiation counts to evaluate normal organ dosimetry, drug localization, and pharmacokinetics of the agent. Clinical responsibilities include screening eligible patients, educating patients about the treatment schedule, and monitoring enrolled patients. This presentation will: 1) provide the scientific knowledge to understand the concepts involved in targeted therapy, 2) describe the therapeutic agent and treatment plan, and 3) discuss the expert role and responsibility of the oncology nurse required to care for patients enrolled in this complex study.