Congress Abstracts 2003

96

PS 341: A NEW DRUG FOR THE TREATMENT OF RENAL CELL CARCINOMA: THE AMBULATORY NURSE’S ROLE. Suzanne Sweeney, RN, BSN, Memorial Sloan-Kettering Cancer Center, New York, NY.

PS 341 is one of a promising new classification of drugs being used to treat metastatic renal cancer. Surgical resection at early stages of the disease is the only curative therapy, and since 50% of those diagnosed already have distant metastasis, and standards therapies are not curative, new forms of therapy are needed. The ambulatory oncology nurse’s role is key in managing and monitoring patients while on investigational protocols, along with intervening and supporting the patient and family throughout treatment.

PS 341 is the first proteasome inhibitor to enter clinical trials. Proteasome degradation system is one of the most efficient processes in living cells; it breaks down complex proteins into simpler ones (proteolysis). Proteasomes play a pivotal role in the cell process, and the inhibition can lead to cell death.

PS 341 is being studied, at this NCI-designated center and other cancer centers, in its ability to arrest tumor growth and tumor spread in renal cancer and various other tumors such as ovarian, lymphoma, multiple myeloma, and prostate cancer.

PS 341 is administered via IV push twice a week for two weeks, followed by a week of rest. The patient is then restaged with a CT scan after two completed cycles. Since this is a new therapy for renal cancer, the ambulatory nurse needs to be prepared for unexpected side effects. The most common side effects reported are loss of appetite, loss of weight, diarrhea, nausea, vomiting, thrombocytopenia, fatigue, and peripheral neuropathy.

The nurse following patients on protocol is responsible for screening for eligibility, maintaining protocol adherence, and symptom management. The nurse assesses and documents symptoms and toxicities and determines symptoms related to drug versus disease progression. When there is disease progression, the nurse is instrumental in providing psychosocial support, referral for alternative therapies, and/or palliative care. This presentation will give an overview of the expert nursing management and strategies developed at this center to care for this population of patients. It will educate the nurse about this new class of drug, its mechanism of action, potential side effects, along with the clinical trial for renal cancer.