At the recent 47th Oncology Nursing Society (ONS) Congress in Anaheim, California, Sherry Adkins, MSN, ANP-C, Advanced Practice Provider Supervisor at MD Anderson Cancer Center, gave a presentation entitled CAR T-Cell Therapy: Care and Considerations Beyond Day 28. She highlighted the fact that although the most common acute toxicities associated with chimeric antigen receptor (CAR) T-cell therapy, including cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS), are well understood, significant knowledge gaps exist regarding lesser-known long-term effects and survivorship care. Following the presentation, Ms. Adkins spoke with Oncology Data Advisor to shed further light on how to optimize follow-up care and survivorship for patients with cancer following CAR T-cell therapy.
Oncology Data Advisor: Thank you for joining us here to speak about your presentation. Would you like to tell us a little about what you do at MD Anderson?
Sherry Adkins, MSN, ANP-C: My name is Sherry Adkins. I'm a nurse practitioner at MD Anderson Cancer Center, and I work in the Lymphoma Department. My specialty is CAR T-cell therapy.
Oncology Data Advisor: So, what are some of the lesser-known long-term effects experienced by patients who are receiving CAR T-cell therapy?
Ms. Adkins: Many people are very familiar with the acute toxic effects that can occur in these patients, which include CRS and neurotoxicities known as ICANS. However, they're often less familiar with some of the long-term and late effects that can occur with this type of therapy. These include cytopenias, B-cell aplasia, and hypogammaglobulinemia, and these toxicities can obviously result in increased risk for infections.
Oncology Data Advisor: Based on your presentation, what is the take-home message that you would like nurses to remember about CAR T-cell therapy and survivorship?
Ms. Adkins: I think one of the most important things to remember is that most of these patients are receiving their CAR T-cell therapy at specialized centers, and they aren't necessarily receiving their follow-up care at the same center. So, it's important for the center that is administering the CAR T cells to communicate this information back to the local oncologist in terms of the monitoring that should be done, the interventions that are necessary, and the need for antimicrobial prophylaxis to prevent infections. Additionally, reporting any secondary malignancies to the manufacturer is very important in these patients.
Oncology Data Advisor: Thanks very much for sharing this advice.
About Ms. Adkins
Sherry Adkins, MSN, ANP-C, is the Advanced Practice Provider Supervisor in the Lymphoma/Myeloma Department at The University of Texas MD Anderson Cancer Center, where she specializes in the research and administration of CAR T-cell therapy. Ms. Adkins worked on the research team for ZUMA-1, the trial which led to the FDA approval of the first CAR T-cell therapy, axicabtagene ciloleucel for large B-cell lymphoma, in 2017.
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Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.