Congress Abstracts 2006

43

BEVACIZUMAB: A NEW TREATMENT FOR NON-SMALL CELL LUNG CANCER? Caroline Clark, RN, and Jeanine Gordon, BSN, OCN^®, Memorial Sloan-Kettering Cancer Center, New York, NY.

In 2005 there will be approximately 172,570 new cases of lung cancer with an estimated mortality rate of 163,510 (ACS, 2004). Given these statistics, development of new treatments for lung cancer is vital. Bevacizumab is currently being studied for treatment of advanced non-small cell lung cancer (NSCLC) as both a single agent and in combination with standard treatments. A National Cancer Institute clinical trial demonstrated that NSCLC patients who received Bevacizumab in combination with standard chemotherapy had a median survival of 12.5 months compared to 10.2 months in those patients who received standard chemotherapy alone.

Bevacizumab is an angiogenesis inhibitor approved by the FDA in 2005 for first line treatment of patients with metastatic carcinoma of the colon or rectum in combination with other standard chemotherapy drugs. Bevacizumab attaches to and inhibits vascular endothelial growth factor (VEGF). In the presence of Bevacizumab, VEGF cannot stimulate new blood vessel formation. This lack of oxygen and nutrients to tumor cells results in decreased tumor growth and survival.

The purpose of this presentation is to inform oncology nurses about this new treatment option for NSCLC and how to monitor and manage the potential side effects. Educating oncology nurses regarding the numerous considerations of treatment with Bevacizumab will ensure safe administration and patient management.

A care plan will illustrate nursing assessment and intervention based on a retrospective chart review of patients treated with Bevacizumab. This care plan will include criteria for treatment, frequency of treatment, pertinent laboratory values, toxicity screening, and evaluation.

After this presentation, oncology nurses will be able to recognize the specific needs of the NSCLC patient receiving Bevacizumab and intervene to make treatment as safe as possible.

Patients receiving Bevacizumab require close monitoring for adverse effects associated with this treatment as well as timely nursing interventions. Severe hypertension, proteinuria, and congestive heart failure have been noted during treatment. Gastrointestinal perforation and wound dehiscence have been reported in the colorectal cancer population. Specific to the NSCLC population is the risk for life-threatening hemoptysis and bleeding leading to disability or death.