Episode 397: Cancer Symptom Management Basics: Ototoxicity
The ONS Podcast
“Referring patients to audiology early on has shown dramatic reduction in hearing loss or complications because the audiologist can really see where were they at before they started chemotherapy, where were they at during, if they get an audiogram during their treatment. And then after treatment, it’s really important for them to see an audiologist because this is really a survivorship journey for them. And as nurses, the ‘so what’: We are the first line of defense,” ONS member Jennessa Rooker, PhD, RN, OCN®, director of nursing excellence at the Tampa General Hospital Cancer...
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Episode 396: Nursing Considerations From the ONS/ASCO Extravasation Guideline
The ONS Podcast
“We proposed a concept to the American Society of Clinical Oncology (ASCO), recognizing that extravasation management requires significant interdisciplinary collaboration and rapid action. There can occasionally be uncertainty or lack of clear guidance when an extravasation event occurs, and our objective was to look at this evidence with the expert panel to create a resource to support oncology teams overall. We hope that the guideline can help mitigate harm and improve patient outcomes,” Caroline Clark, MSN, APRN, AGCNS-BC, OCN®, EBP-C, director of guidelines and quality at ONS, told...
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Episode 395: Pharmacology 101: Monoclonal Antibodies
The ONS Podcast
“They [monoclonal antibodies] are able to cause tumor cell death by binding to and blocking to necessary growth factor signaling pathways for tumor cell survival. That’s going to be dependent on the target of the antibody, but I’ll give an example of epidermal growth factor, or EGFR. This is overexpressed in several different kinds of cancers where activation of this growth factor increases the amount of proliferation and migration of cancer cells. So, if we bind to it and block to it, then that would help halt these pathways and stop cancer cell growth,” Carissa Ganihong, PharmD,...
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Episode 394: Prostate Cancer Survivorship Considerations for Nurses
The ONS Podcast
“The thought of recurrence is also a psychosocial issue for our patients. They’re being monitored very closely for five years, so there’s always that thought in the back of their head, ‘What if the cancer comes back? What are the next steps? What am I going to do next?’ It’s really important that we have conversations with patients and their families about where they’re at, what we’re looking for, and reassure them that we’ll be with them during this journey and help them through whatever next steps happen,” ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager...
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Episode 393: Antibody–Drug Conjugates in Metastatic Breast Cancer
The ONS Podcast
“I’ll go back to the backpack analogy. When your kids come home with a backpack, all of a sudden their homework is not on the desk where it’s supposed to be. It’s in the kitchen; it kind of spreads all over the place, but it’s still in the house. When we give antibody–drug conjugates (ADCs), the chemotherapy does go in, but then it can kind of permeate out of the cell membrane and something right next to it—another cancer cell that might not look exactly like the cancer cell that the chemotherapy was delivered into—is affected and the chemotherapy goes over to that cancer cell...
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Episode 392: ONS 50th Anniversary: Stories From the Other Side of Cancer
The ONS Podcast
“Working as an oncology infusion nurse, being oncology certified, attending chapter meetings, going to ONS Congress® has really taught me plenty. But being an oncology patient taught me way more. I know firsthand the fears ‘you have cancer’ brings. Then going through further testing, CT scans, MRIs, genetics, the whole preparation for surgery was something I never considered when I treated a breast cancer patient,” ONS member Catherine Parsons, RN, OCN®, told Valerie Burger, MA, MS, RN, OCN®, CPN, member of the ONS 50th anniversary planning committee, during a conversation about...
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Episode 391: Pharmacology 101: Antibody–Drug Conjugates
The ONS Podcast
“Antibody–drug conjugates (ADCs) have three basic parts: the antibody part, the cytotoxic chemo, and the linker that connects the two. First, the antibody part binds to the target on the surface of the cell. Antibodies can be designed to bind to proteins with a very high level of specificity. That’s what gives it the targeted portion. Then the whole thing gets taken up by the cell and broken down, which releases the chemotherapy part. Some sources will call this the ‘payload’ or the ‘warhead.’ That’s the part that’s attached to the ‘heat-seeking’ part, and that’s...
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Episode 390: Prostate Cancer Treatment Considerations for Nurses
The ONS Podcast
“Any time the patient hears the word ‘cancer,’ they shut down a little bit, right? They may not hear everything that the oncologist or urologist, or whoever is talking to them about their treatment options, is saying. The oncology nurse is a great person to sit down with the patient and go over the information with them at a level they can understand a little bit more. To go over all the treatment options presented by the physician, and again, make sure that we understand their goals of care,” ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager of clinical education and...
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Episode 389: Biomarker Testing for Non-Small Cell Lung Cancer
The ONS Podcast
“It’s critical to identify those mutations found that are driving the cancer’s growth and guide the personalized treatment based on those results. And important to remember, too, early testing is crucial for patients with non-small cell lung cancer (NSCLC). In studies, it has been found to be associated with improved survival outcomes and reduced mortality,” ONS member Vicki Doctor, MS, BSN, BSW, RN, OCN®, precision medicine director at the City of Hope Atlanta, GA, Chicago, IL, and Phoenix, AZ, locations, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing...
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Episode 388: ONS 50th Anniversary: Milestones in Oncology Advocacy and Health Policy
The ONS Podcast
“I think we really need to push more of our oncology nurses to get into elected and appointed positions. So often we’re looking at health positions to get involved in, and those are wonderful. We need nurses as secretaries of health, but there are others. We as nurses understand higher education. We understand environment. We understand energy. So I think we look broadly at, what are positions we can get in? Let’s have more nurses run for state legislative offices, for our House of Representatives, for the U.S. Senate,” ONS member Barbara Damron, PhD, LHD, RN, FAAN, told Ryne Wilson,...
info_outline“They [monoclonal antibodies] are able to cause tumor cell death by binding to and blocking to necessary growth factor signaling pathways for tumor cell survival. That’s going to be dependent on the target of the antibody, but I’ll give an example of epidermal growth factor, or EGFR. This is overexpressed in several different kinds of cancers where activation of this growth factor increases the amount of proliferation and migration of cancer cells. So, if we bind to it and block to it, then that would help halt these pathways and stop cancer cell growth,” Carissa Ganihong, PharmD, BCOP, oncology and bone marrow transplantation clinical pharmacist at Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about monoclonal antibodies.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.75 contact hours of nursing continuing professional development (NCPD) (including 45 minutes of pharmacotherapeutic content) by listening to the full recording and completing an evaluation at courses.ons.org by December 26, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge in the history of, the mechanism of action of, and the use of monoclonal antibodies in the treatment of cancer.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- Pharmacology 101 series
- Episode 391: Pharmacology 101: Antibody–Drug Conjugates
- Episode 383: Pharmacology 101: Bispecific Antibodies
- Episode 375: Pharmacology 101: VEGF Inhibitors
- Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse’s Role
- Episode 283: Desensitization Strategies to Reintroduce Treatment After an Infusion-Related Reaction
- Episode 275: Bispecific Monoclonal Antibodies in Hematologic Cancers and Solid Tumors
- ONS Voice articles:
- An Oncology Nursing Overview of Biosimilars
- Make Subcutaneous Administration More Comfortable for Your Patients
- Oncology Nurses’ Role in Translating Biomarker Testing Results
- Reduce Chair Time by as Much as 16 Minutes by Priming IVs With Drug
- Shorter Administration Times Still Require High-Acuity Care
- The Names of Targeted Therapies Give Clues to How They Work
- ONS Voice drug reference sheets:
- ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
- ONS course: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
- Clinical Journal of Oncology Nursing articles:
- Bolusing IV Administration Sets With Monoclonal Antibodies Reduces Cost and Chair Time: A Randomized Controlled Trial
- Management of Immunotherapy Infusion Reactions
- Nurse-Led Grading of Antineoplastic Infusion-Related Reactions: A Call to Action
- Safety and Adverse Event Management of VEGFR-TKIs in Patients With Metastatic Renal Cell Carcinoma
- Oncology Nursing Forum articles:
- ONS huddle cards:
- Other ONS resources:
- Patient Education Sheets
- Antibodies article: A Comprehensive Review About the Use of Monoclonal Antibodies in Cancer Therapy
- Cureus article: A Comprehensive Review of Monoclonal Antibodies in Modern Medicine: Tracing the Evolution of a Revolutionary Therapeutic Approach
- Association of Cancer Care Centers (ACCC) homepage
- Cancer Immunology, Immunotherapy article: Therapeutic Antibodies in Oncology: An Immunopharmacological Overview
- Drugs@FDA package inserts
- Future Oncology article: Biosimilars: What the Oncologist Should Know
- Hematology/Oncology Pharmacy Association homepage
- National Comprehensive Cancer Network homepage
- Network for Collaborative Oncology Development and Advancement (NCODA) subcutaneous therapy article
- Oncolink: Side Effects of Immunotherapy
- World Health Organization: New International Nonproprietary Names (INN) Monoclonal Antibody Nomenclature Scheme
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From This Episode
“Prior to monoclonal antibodies, all we really had were these toxic chemotherapies or toxic radiation, so it was recognized how great it would be if we could have a treatment that was much more specific to the tumor cells and have agents that have less toxicities. These advancements in monoclonal antibody production began in the 1980s. ... Eventually, we had the first monoclonal antibody that was approved by the U.S. Food and Drug Administration (FDA) for an oncologic indication, rituximab.” TS 4:14
“Nowadays, we do have treatments that are also considered tumor-agnostic. This is when a patient has a certain biomarker, then that treatment can be given and FDA approval was given, regardless what type of tumor the patient has. We typically see these kinds of tumor-agnostic therapies more so in patients who have recurrent or advanced diseases in solid tumors. One monoclonal antibody example that comes to mind is dostarlimab. That’s a checkpoint inhibitor that’s approved for patients who are deficient in mismatch repair mechanism.” TS 23:48
“Our immune system constantly has this surveillance system and it’s able to recognize foreign pathogens, abnormal cells, and even precancerous cells. And they’re able to eliminate them before they become cancerous. But on the flip side, one of the regulatory mechanisms that we have so our immune system doesn’t attack itself is the presence of checkpoints. When these checkpoints bind to their ligands, this can then act as an off switch so that, again, our immune system is not going to attack itself. But then the tumor cells can take advantage of this and actually use this mechanism to evade the immune system. So, when we’re giving a checkpoint inhibitor, now we’re removing that off switch. As a consequence, common adverse effects can include things like immune mediated adverse events. These most commonly affect the skin, gastrointestinal tract, and liver. Essentially, this can cause any ‘-itis’ you can think of.” TS 26:36
“Looking at strategies to prevent infusion reactions, one example is the use of premedication. If premedication is recommended, this typically includes any combination of antipyretics, which is typically acetaminophen. Antihistamine, which is typically an H1 antagonist like diphenhydramine. Although, there could be cases where we want to substitute this agent because maybe the patient has been tolerating therapy okay, and they’re having a lot of side effects. So, we might use a second-generation antihistamine in some cases. The premedication may be given with or without some kind of steroid, whether that’s methylprednisolone, hydrocortisone, or dexamethasone.” TS 29:53
“We tend to think of monoclonal antibody usage to be primary oncology, but that’s not really the case. The first monoclonal antibodies that were developed were not for oncologic indications, they were for transplant indication for cardiac indication. So, they’re really diversely utilized across all specialties and medicines. We have monoclonal antibodies for hyperlipidemia, for neurology, for rheumatology, so the uses are so very expansive across all specialties.” TS 41:01