Nursing Perspectives on Managing Toxicities With ADCs in Metastatic Gastric and Breast Cancers

In this episode of The Vitals, a panel of oncology nurses and nurse practitioners with backgrounds in gastric and breast cancer unpack adverse event (AE) management with anti-body drug conjugates (ADCs). 

Sarah Donahue, MPH, NP, AOCNP, of the University of California San Francisco Health recently moderated a discussion with Jamie Carroll, APRN, CNP, MSN, of the Mayo Clinical in Rochester Minnesota; Theresa Wicklin Gillespie, PhD, MA, RN, FAAN, of the Winship Cancer Institute with Emory University; and Elizabeth Prechtel-Dunphy, DNP, RN, ANP-BC, AOCN of the Abramson Cancer Center with the University of Pennsylvania. The Peer Exchange program was structured to highlight real-world scenarios to put best nursing practices into context when using approved ADCs in clinic. 

Following a case study presented by Gillespie on a woman with metastatic gastric cancer who developed neutropenia while receiving fam-trastuzumab deruxtecan-nxki (Enhertu), the panel discuss the other potential AEs associated with this treatment—including neuropathy, nausea, and interstitial lung disease. They compare the rate of incidences for these AEs between gastric and breast cancers, pose questions regarding the value of interdisciplinary collaboration with pulmonary teams, and pitch questions regarding agent suitability for patients with pre-existing comorbidities. 

Basing their conversation around published clinical trial data and experience from their personal practice, they discuss how to best manage these events, wrapping up with clinical pearls for all oncology nurses who care for patients receiving an ADC for metastatic disease.