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Personalizing Lung Cancer Care Through Biomarkers and Precision Medicine With Blanca Ledezma, MSN, NP

In this interview with Oncology Data Advisor, Blanca Ledezma, MSN, NP, elucidates the current landscape of therapeutically actionable biomarkers in lung cancer and the promising future of precision medicine in this field. In addition, she explains the clinical applications for lung cancer biomarkers in nursing practice, including unique toxicity management and patient education for novel therapies.  

Oncology Data Advisor: Welcome to Oncology Data Advisor. Today I'm speaking with Blanca Ledezma, who is a Nurse Practitioner at the University of California, Los Angeles (UCLA) Santa Monica. Thank you so much for joining us today.

Blanca Ledezma, MSN, NP: I'm Blanca Ledezma. I'm a Nurse Practitioner here in Santa Monica at UCLA Outpatient Oncology. I've been a Nurse Practitioner for over 18 years. My focus is thoracic malignancies. I work with both the clinical research and with the standard of care patients. That's a little bit of what I do.

Oncology Data Advisor: Thank you. So, for background, what are the therapeutically actionable biomarkers in lung cancer at the moment?

Ms. Ledezma: At the moment, we have a lot more than we did a few years back when I first started, which makes it an exciting time. We have epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), ROS1, BRAF, NTRK, RET, MET exon 14 skipping, KRAS, and then human epidermal growth factor receptor 2 (HER2).

Oncology Data Advisor: Great. What are the biomarkers that are currently being studied, and how do you think the field is going to evolve in the coming years?

Ms. Ledezma: The field is constantly evolving, which is the beauty of doing clinical research. We always want to provide patients with newer therapeutic options and utilize more precision medicine aimed at the individual tailored disease for each patient.

The new markers that are being studied or evaluated are STK11, KEAP1—which could be a predictor of how patients will respond to immunotherapy—and human leukocyte antigen (HLA). That can also be a predictor of outcomes with immunotherapy. Another marker is the NRG1 fusion, which is another potential actionable fusion. Hopefully in the near future, with more research, that can be actionable.

Oncology Data Advisor: With all of these new biomarkers, the ones that are currently used as well as the new ones, what are the clinical applications for nursing practice?

Ms. Ledezma: There are a lot of applications in nursing. The applications are knowing the therapeutic treatments for those particular actionable mutations and knowing the potential toxicities. Nurses will potentially see these patients, whether it's for an infusion and helping manage the toxicities with infusional supportive treatments, or they may be doing the phone calls and helping manage these patients and triaging these patients. Nurse navigators may be helping with the symptom management of these patients.

For a lot of these symptoms, it's going to be really important to know the oral therapeutic treatments or the infusional therapeutic treatments that are given and are directed to these individual actionable mutations. We need to know what the potential toxicities are and how to recognize them and how to manage them.

Oncology Data Advisor: Is there anything else you'd like to share about this topic?

It's just such an exciting time. We now have all these actionable treatments that are directed to the individual disease, and we get to provide patients with more therapeutic treatments and use precision medicine for the individual disease, the tumor itself, and the individual patient.

"Ms. Ledezma: It's just such an exciting time. We now have all these actionable treatments that are directed to the individual disease, and we get to provide patients with more therapeutic treatments and use precision medicine for the individual disease, the tumor itself, and the individual patient. It's not "one size fits all." It's just such an exciting time in which we can provide patients with more treatment options that are more directed to the individual.

Oncology Data Advisor: Definitely, it's very exciting. Thank you so much for explaining all of this.

Ms. Ledezma: Absolutely.

About Ms. Ledezma

Blanca Ledezma, MSN, NP, is a Nurse Practitioner in Hematology/Oncology at UCLA Santa Monica Medical Center, where she cares for patients with lung cancer who are receiving standard-of-care treatments and those who are receiving novel therapies in clinical trials. She has been a Nurse Practitioner for 18 years and was involved in the early clinical trials for immunotherapy in lung cancer. Ms. Ledezma is a well-recognized speaker on the topics of unique toxicity management, early symptom intervention, and optimal management of immunotherapies.

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor. 


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