NCI at ONS 2017 Highlights

NCI at ONS 2017 Highlights

NCI at ONS 2017 From the National Cancer Institute Please note that all times listed are in local Denver time (MDT) Join NCI at the Oncology Nursing Society (ONS) 42nd Annual Congress to be held in Denver, CO, May 4th - 7th, 2017. ONS is the most comprehensive oncology nursing conference in the country and is committed to promoting excellence in oncology nursing and the transformation of cancer care.   Visit NCI Exhibit Booth #1124 Make sure to stop by the NCI booth to meet with NCI experts listed below, learn about NCI programs and initiatives, and find out how you can order NCI patient education publications.     Booth hours: May 4th   11:00 AM - 4:15 PM May 5th   11:00 AM - 4:15 PM May 6th   11:00 AM - 2:45 PM   Meet the Experts Stop by the NCI booth to ask questions regarding clinical trials, healthcare delivery research, cancer survivorship, and the NCI Community Oncology Research Program.   Thursday, May 4th, 11:00 AM - 12:00 PM Sonia Bellfield, MSN, OCN, RN Sonia Bellfield joined the NCI Center for Cancer Research in 2016 as a Clinical Research Nurse Coordinator and has been working with cancer patients since the start of her career in 2002.  Initially, she worked as an inpatient nurse on an oncology floor providing care to patients during all phases of their cancer treatment at Virginia Hospital Center in Arlington, Virginia. From 2005-2013, she worked as an oncology research infusion nurse at MedStar Georgetown University Hospital in Washington, DC, administering an array of research treatments for patients enrolled in Phase 1 through Phase 3 clinical trials for every type of cancer. In 2011, she obtained her Master’s Degree in Nursing Education at Georgetown University and taught second-degree nursing students at Georgetown and Marymount University in the classroom and in the hospital. Her current area of specialization is bladder cancer where her team is led by Dr. Piyush Agarwal from NCI’s Urology Branch.     Friday, May 5th, 1:45 PM - 2:45 PM Kathleen Castro, RN, MS, AOCN Kathleen Castro, RN, MS, AOCN® is a Nurse Consultant in the NCI Division of Cancer Control and Population Sciences, Office of the Associate Director of the Healthcare Delivery Research Program. Ms. Castro's research interests are in clinical effectiveness of cancer care delivery; quality reporting to measure processes and outcomes of care delivery; and cancer care delivery in community-based cancer programs. Ms. Castro's prior experience includes 13 years as a Stem Cell Transplant Coordinator at the NCI, Georgetown University and George Washington University and five years as an Oncology Clinical Nurse Specialist at the NIH Clinical Center and Georgetown University Medical Center. Ms. Castro serves as a Program Director for the Cancer Care Delivery Research component of the NCI Community Oncology Research Program (NCORP), a consortium of seven Research Bases and 46 community oncology practices, hospitals, and integrated health systems to support NCI's clinical trials program and cancer care delivery research in community-based oncology practice. She led the NCI Community Cancer Centers Program (NCCCP) Quality of Care initiatives within the consortium of 21 community-based cancer centers and health systems in 16 states devoted to bring clinical trials and evidence based practice into community oncology care. She has collaborated with the American College of Surgeons Rapid Quality Reporting System team and the American Society of Clinical Oncology Quality Oncology Practice Initiative team to integrate national quality reporting initiatives into the NCCCP program. Ms. Castro is the Principal Investigator for multi-site protocols investigating processes and outcomes of multidisciplinary care as well as quality measurement in community settings. Ms. Castro has published on quality outcomes and cancer care delivery in peer-reviewed publications and has presented at the ASCO Annual Meeting, ASCO Quality Symposium and ONS Congress.   Saturday, May 6th, 11:30 AM - 12:30 PM Nonniekaye Shelburne, CRNP, MS, AOCN Ms. Shelburne is a Program Director in the NCI Division of Cancer Control and Population Sciences, Epidemiology and Genomics Research Program's (EGRP) Clinical and Translational Epidemiology Branch (CTEB). She is responsible for facilitating research consortia, epidemiology research on cancer treatment outcomes and toxicity and the development of benefit-risk prediction models related to cancer treatment outcomes and toxicity. She also has an adjunct research appointment focusing on problem solving interventions, symptom management, and quality-of-life trials at the NIH Clinical Center. Before joining EGRP in 2010, Ms. Shelburne was an Acute Care Nurse Practitioner and Oncology Clinical Nurse Specialist with the Hematology and Stem Cell Transplant Program of Care at the NIH Clinical Center. From 1998-2004, she was a Clinical Research Nurse within the same program. Her focus was on improving the clinical and research outcomes of patients in phase I and II clinical trials for cancer and hematological disorders. Ms. Shelburne was an Associate Investigator on clinical trials. Ms. Shelburne is an Advanced Oncology Certified Nurse (A.O.C.N.) and a Certified Registered Nurse Practitioner (C.R.N.P.) in Acute Care Oncology. Sessions Featuring NCI Staff Thursday, May 4th, 2017 Myelodysplastic syndrome: Is it just that? The importance of obtaining an accurate family history 5:30 PM - 6:30 PM Colorado Convention Center - ePoster Pavilion (Hall C) Up to 72 percent of adolescents with myelodysplastic syndrome (MDS), and monosomy 7 have the GATA2 mutation. Patients with GATA2 deficiency can present with atypical mycobacterial infections, severe viral infections, human papilloma virus, lymphedema, MDS, and acute myeloid leukemia (AML). Infections result from low monocytes, natural killer cells, and B-lymphocytes in the peripheral blood. Approximately one-half of the cases of GATA2 deficiency result from a germline mutation and is heritable. GATA2 deficiency functions by haploinsufficiency loss of one copy of the gene results in disease. Each member of a family of an affected individual has a 50:50 chance of inheriting the defective allele. Purpose & Innovative: Oncology nurses and providers are in a unique position to impact these outcomes by obtaining detailed and accurate family histories to optimize treatment decisions, especially for patients with MDS and/or AML. Research has shown that GATA2 patients that undergo stem cell transplantation prior to development of life-threatening infections or cytogenetic abnormalities have better outcomes. Interventions: An accurate family history is a valuable, inexpensive, and often underused tool, the opportunity exists to identify individuals with a predisposition to cancer. By eliciting a detailed three-generation pedigree (family history), oncology nurses can identify whether an underlying genetic mutation may be the cause of a disease, and if screening is indicated for the individual patients and family members. Evaluation & Results: To illustrate the significance of a detailed family history, we offer as an example, a 38-year-old male diagnosed with recurrent infections suggestive of GATA2 (disseminated atypical mycobacterial infection, anal condylomata, pulmonary alveolar proteinosis, and MDS). His peripheral blood was notable for monocytopenia, B and NK cell lymphopenia. GATA2 testing confirmed a mutation. His family history revealed four asymptomatic siblings, and a cousin who died of leukemia. His 8-year-old son has had nose bleeds, warts, and asthma. His 16-year-old son had a healthy childhood, however he was found to be neutropenic, and a bone marrow revealed MDS. Both children were found to have the GATA2 mutation. Discussion: Oncology nurses, and provider armed with knowledge of MDS and GATA2 deficiency can play a critical role by obtaining extensive three-generation family pedigrees to identify patients and their family members who may need genetic testing to provide the highest level of care. Friday, May 5th, 2017The role of medical skills training in caregiver confidence and burden: A CanCORS study 7:00 AM - 8:00 AM Colorado Convention Center - ePoster Pavilion (Hall C) Informal cancer caregivers provide essential support to cancer patients, including delivery of direct medical care (e.g., managing symptoms, administering treatment), assistance with activities of daily living, and provision of social support. A number of evidence-based interventions exist to address the burden caregivers often experience. Most, however, focus on building coping skills and stress management. Less is known about the impact of skills training to both increase confidence and mitigate burden. We examined (1) the association between receipt of medical skills training and reduction in caregiver burden, and (2) whether training influenced burden through increasing caregivers' confidence in their ability to care for the survivor's physical needs. Methods/Analysis: Caregivers identified by lung and colorectal cancer patients in the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium completed a mailed questionnaire that assessed demographic characteristics, type of care provided, type of medical skills training needed and received, burden (as measured by the short-form Zarit Burden Interview), and confidence in caring for physical needs of the care recipient. Univariate and multivariable regressions adjusting for sociodemographic, caregiving, and care recipient characteristics assessed the relationship between training received and burden, and mediation analysis using Sobel's test assessed the role of confidence in this relationship. Findings and Interpretation: Fifty-nine percent of caregivers reported that they did not receive the training that they needed. Caregivers reported moderate levels of burden (mean summary score = 32.07, SD = 12.66, range 14-70), consistent with previous studies. Lack of receipt of training was associated with greater levels of burden (b = 2.60; SE 0.98; p-=0.01). Confidence partially mediated the relationship between training and burden (Sobel's t =1.90; p= 0.03). Discussion and Implications: The results indicate that training is a potential area for interventions to reduce caregiver burden. Future research on how best to provide training for caregivers (in terms of content, mode of delivery, timing) is needed. Innovation: This is the only known study which examines associations between medical/nursing skills training, confidence and burden in a large, multi-site study of cancer caregivers reported from caregivers themselves. Saturday, May 6th, 2017 Applying What is Known About Immuno-oncology to Your Practice Today 9:45 AM - 11:00 AM Colorado Convention Center - Mile High Ballroom 4 D-F Immuno-oncology agents are quickly becoming treatment options for many cancer diagnoses. There are many challenges when caring for patients receiving these new treatments because there is little evidence about safe handling, administration, follow up, and side effect management. This becomes even more complicated when immuno-oncology treatments are given to patients who have failed previous treatments and/or when these agents are included in multi-modality regimens. Join nursing thought leaders in immuno-oncology as they present best practices and emerging data on nursing implications for immuno-oncology therapies and priorities for patient and family caregiver education, and come ready to share your own experiences. Nursing Implications of Chimeric Antigen Receptor T-Cell Therapy 10:05 AM - 10:25 AM Colorado Convention Center - Mile High Ballroom 4 A-C Chimeric Antigen Receptor T cells (CAR T cells) are human T cells that are genetically modified to express a CAR immunoreceptor that allows the cells to target specific surface proteins on cancers. CAR T cells are an emerging therapy for acute lymphoblastic leukemia, chronic lymphocytic leukemia, lymphoma, and multiple myeloma. While the results for patients are promising, the side effects of the cells, while transient, may be severe or life threatening. The purpose of this abstract is to describe common side effects related to Chimeric Antigen Receptor T cells and highlight the significance of appropriate identification of symptoms by nursing.The most well-known side effect of CAR T cells is cytokine release syndrome (CRS). This syndrome is caused when the CAR T cells recognize the target on the patient's cancer and release cytokines. The most common expression of CRS that nurses need to assess for are fevers that can exceed 40 degrees Celsius and last several days along with hypotension that can become severe enough that the patient requires transfer to the intensive care unit for hemodynamic support. Other CRS related side effects to assess for include, but are not limited to: hypoxia, cardiac arrhythmias, acute kidney injury, cytopenias, and myalgia. Careful nursing assessment for neurological toxicities is also essential as these symptoms may or may not correspond directly with CRS. (Some examples of neurological side effects are headaches, confusion, tremors, ataxia, dysphasia, and seizures.) Nursing monitoring and recognition of these symptoms can allow early detection of CAR T-cell toxicities. Due to the potential severity of these side effects, nursing's ability to understand and identify signs and symptoms can allow them to play a vital role in early intervention and safe management of the patient by the multidisciplinary team. If symptoms become severe enough, a patient may require that the effect of the T-cells be tempered with tocilizumab or corticosteroids, however, this is avoided if possible to prevent damaging the anti-malignancy effect of the CAR T cells. Having established supportive care guidelines for adult patients receiving CAR T cells can allow nursing to know what signs and symptoms to monitor for and communicate to the medical team to allow early intervention. This can help prevent confusion and provide clear guidelines in the patient's care. Roundtable Discussion on Research Funding Opportunities 1:45 PM - 2:45 PM Colorado Convention Center - Networking Roundtables (Hall C) Learn about current funding mechanisms and discover how to best position your research program to succeed in obtaining funding from the NIH, the ONS Foundation, and the National Institute of Nursing Research. Be sure to attend this exciting opportunity for researchers at all levels.   Also of Interest   Looking for a Clinical Trial? With our new basic search form, you can find a trial or contact the NCI for help via phone, email, or online chat.    NCI Dictionary of Cancer Terms Look up easy-to-understand definitions for more than 8,000 words and phrases related to cancer and medicine.   Annual Report on the Status of Cancer Updated rates for new cases, deaths, and trends for the most common cancers in the United States, including a special section on cancer survival.