Congress Abstracts 2004

72

THE AMBULATORY ONCOLOGY NURSE’S ROLE IN THE USE OF CONJUGATE VACCINES FOR PROSTATE CANCER. Gabrielle Arauz, RN, BSN, Memorial Sloan Kettering Cancer Center, New York, NY.

At this NCI-designated cancer center, we are exploring the use of conjugate vaccine therapy as an alternative approach for the treatment of biochemically relapsing prostate cancer. These patients have a rising prostatic specific antigen (PSA) without radiographic evidence of disease. The oncology nurse plays a vital role by providing information about vaccine therapy, monitoring side effects, and providing expert nursing intervention in the management of symptoms related to disease and/or its therapy.

Despite earlier diagnoses, many men will progress after radiation and/or prostatectomy (primary treatment). These men are now faced with a diversity of issues including no curative therapy, fear of mortality, and the adverse side effects associated with hormonal therapy, which is the mainstay of treatment. Vaccine therapy offers this population a viable alternative.

The objective of these vaccines is to develop an immunologic response by generating titer antibodies targeted toward specific prostatic antigens on the cell surface. To date, 200 men with rising PSA have been on different phase I and II conjugate vaccine trials at our center, with minimal toxicities such as swelling, itching, and redness at the injection site and flu-like symptoms. Conjugate vaccines generate immunologic responses to promote cancer cell death and are made up of various synthetic molecules which mimic naturally occurring sugars found on prostate cancer cells.

The nurse monitoring patients on trial is responsible for evaluating patients for eligibility, maintaining adherence to protocol standards, and monitoring toxicities. Depending on the trial, vaccines are given monthly for 4–6 months. Response is monitored at 3–4 month intervals with PSA monitoring, immunologic titers, comprehensive blood work, and radiographic imaging. The oncology nurse acts as coordinator and liaison between all participating disciplines and is integral in optimizing outcomes of the treatment by providing education about the rationale of vaccine therapy, intervening as necessary for symptom management, monitoring and evaluating side effects, along with assessing overall response to treatment.

This presentation will give an overview of vaccine trials used in prostate cancer, the mechanisms of action, and the expert nursing knowledge necessary to provide care to this specific population of oncology patients.