WHAT WAS LEARNED?


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Data from phase 3 trials have shown that rolapitant may significantly improve quality of life in patients receiving either HEC or MEC. In addition, the agent may help with patient nonadherence because of its single oral administration prior to chemotherapy. Rolapitant has a long half-life (plasma half-life of approximately 7 days) and so it provides longer sustained efficacy than other NK-1 receptor antagonists. It is associated with only mild-to-moderate adverse effects based on several clinical trials with thousands of cancer patients.

Cindy Samborski, MSN, MHA, RN, a clinical research educator at Roswell Park Cancer Institute, Buffalo, New York, said the oncology nurse’s role is to thoroughly understand CINV, educate the patient, be proactive in prevention, identify early onset, and suggest interventions. “The importance of this issue can directly impact outcome of treatment for the patient, compliance with therapy, and with receiving the correct strength of chemotherapy doses,” Ms Samborski told Oncology Nurse Advisor. “The nurse has the ability to improve a patient’s quality of life through education and assessment, and medications.”

IMPLICATIONS FOR NURSES

Dr Rapoport writes that acute CINV has been improved disproportionately to date compared with delayed CINV, particularly among those patients who receive HEC. Medical oncologist Elizabeth Wulff-Burchfield, MD, Vanderbilt University Medical Center, Nashville, Tennessee, said oncology nurses play pivotal role in addressing this deficit. Dr Wulff-Burchfield said the current article raises a number of important points, including that a layered approach is most effective for these medications when managing delayed CINV.

“The chemotherapy counseling and consent process that takes place between patients and oncologists often covers a wide array of possible consequences from treatment, both positive and negative. Oncology nurses, both in the clinic and in the infusion room, can provide valuable guidance to patients and caregivers by reiterating the most pertinent symptoms and illustrating a practical management algorithm,” Dr Wulff-Burchfield told Oncology Nurse Advisor.

She said the old saying of “forewarned is forearmed” absolutely holds true for symptom management in this clinical setting. “Oncology nurses are often the people who help patients and caregivers synthesize this knowledge and empower them to act on it,” explained Dr Wulff-Burchfield.