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“Because the premise of immune checkpoint blockade centers around elevating the immune function, we should always take a great deal of caution around those patients who have high immune risks. Those include patients with autoimmune disorders. That’s one of our biggest questions that we ask, usually every consult that we’re seeing with solid tumor. ‘Do you have any history of autoimmune disorders? Tell me a little bit more about it. Is it being treated? What are your symptoms like?’ And then also patients who have undergone organ transplants. Now, interestingly, this does include stem...
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“It’s important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education,” ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager...
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“You also want to deal with patient preferences. We do want to get their disease under control. We want to make them live a long, good quality of life. But do they want to come to the clinic once a week? Is it a far distance? Is geography a problem? Do they prefer not taking oral chemotherapies at home? We have to think about what the patient’s preferences are to some degree and kind of incorporate that in our decision-making plan for treatments for relapsed and refractory myeloma,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University...
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“Radioimmunoconjugates work through a dual mechanism that combines immunologic targeting with localized radiation delivery. The monoclonal antibody components bind to specific tumor-associated antigens such as CD20, expressed on malignant B cells. Once found, the attached radioisotope delivers beta radiation directly to the tumor, causing DNA damage and cell death,” Sabrina Enoch, MSN, RN, OCN®, CNMT, NMTCB (CT), theranostics clinical specialist at Highlands Oncology in Rogers, AR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...
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“The United States does not have a national cancer registry. We have a bunch of state registries. Some of those registries do collaborate and share information, but the issue is the registries that do exist typically do not report cancer by occupation. So, we cannot get our arms around the potential work-relatedness of the health outcome given the current way the state registries collect information. What we’re trying to set up, is a way to make what is currently an invisible risk, visible,” ONS member Melissa McDiarmid, MD, MPH, DABT, professor of medicine and epidemiology and public...
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“[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It’s very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it’s our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer...
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“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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“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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“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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“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...
info_outline“Radioimmunoconjugates work through a dual mechanism that combines immunologic targeting with localized radiation delivery. The monoclonal antibody components bind to specific tumor-associated antigens such as CD20, expressed on malignant B cells. Once found, the attached radioisotope delivers beta radiation directly to the tumor, causing DNA damage and cell death,” Sabrina Enoch, MSN, RN, OCN®, CNMT, NMTCB (CT), theranostics clinical specialist at Highlands Oncology in Rogers, AR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radioimmunoconjugates.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 30, 2027. 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 radioimmunoconjugates in the treatment of cancer.
Episode Notes
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- ONS Podcast™ episodes:
- ONS Voice articles:
- Interprofessional Collaboration Reduces Time to Neutropenia Antibiotic Administration
- Radiopharmaceuticals and Theranostics Offer New Options for Oncology Nurses to Transform Cancer Care
- Radiopharmaceuticals Pack a One-Two Punch Against Cancer
- Safety Is Key in Use of Radiopharmaceuticals
- Telehealth Has Value During Radiotherapy, Patients Say
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- Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
- Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
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Highlights From This Episode
“Radioimmunoconjugates are a specialized subset of radiopharmaceuticals designed to combine the specificity of monoclonal antibodies with the cytotoxic power of radiation. ... Early development focused on B-cell malignancies, particularly non-Hodgkin lymphoma.” TS 1:51
“An important concept for nurses to understand is the crossfire effect, where radiation can affect nearby tumor cells, even though not every cell expressed has the target antigen. This helps explain why these agents can be effective even in heterogeneous tumors.” TS 3:40
“At present, 90 Y-ibritumomab tiuxetan is the only radioimmunoconjugate approved by the U.S. Food and Drug Administration (FDA) in clinical use. Historically, iodine-131 tositumomab played a major role in establishing these therapy classes, but it’s also useful to contrast radioimmunoconjugates with other radiopharmaceuticals, such as iodine-131 therapies, which a lot of places do at this time, used for thyroid diseases, or radium 223, used for metastatic prostate cancer. Unlike those agents, radioimmunoconjugates rely on antibody-mediated targeted rather than physiologic uptake or bone affinity.” TS 4:55
“I just try to explain to [patients] that radiation exposure is like being next to a flame. The further you are away, the less heat you get, the less exposure you get. These patients can be radioactive for three days, seven days—it just depends on how fast they excrete it through their bodies with half-life exposure.” TS 9:33
“While only one agent is currently approved, the principles established by radioimmunoconjugates continue to guide development for newer targeted radiopharmaceuticals. Emerging agents aim to improve targeting, reduce toxicity, and expand indications beyond hematologic malignancies. This evolution underscores the importance of nursing education in this rapidly changing field.” TS 10:41
“Radioimmunoconjugates represent an important bridge between traditional oncology treatments and the future of targeted therapies. Oncology nurses play a vital role in ensuring safe delivery, patient understanding, and collaboration between multidisciplinary teams. So, it’s very important to educate and also stay up to date on evidence-based practices.” TS 13:12