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Episode 406: Drug Resistance Biomarkers and Their Impact on Cancer Treatment Choices

Release Date: 03/13/2026

Episode 432: Long-Term Chronic Lymphocytic Leukemia Considerations for Oncology Nurses

The ONS Podcast

“It’s a chronic disease. It never goes away for some people, and so therefore it has these periods of remission where it’s really quiet and well controlled. Then there can be periods of flares where you’re actively engaged in treatment or it’s impacting other pieces. There’s this feeling patients have of, ‘When am I going to have that flare?’ You know, this anticipatory anxiety of, ‘When are things going to be done differently?’ or ‘When do I need to change?’” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer...

Episode 431: Oncologic Emergencies 101: Urinary Obstruction

The ONS Podcast

“Think about all the important things our kidneys do for the body. Those things are compromised. If we have excess buildup of toxins and waste in the body, you’re having problems with fluid reabsorption. Then you have also problems with electrolytes not being balanced. Then in turn, you have ongoing shutdown of systems. So the cardiopulmonary system gets compromise. Your circulatory system then gets compromised. And then all the things in the body that depend upon ongoing circulatory flow are then causing major resets in the system that need to be addressed,” ONS member Brenda S....

Episode 430: Leadership Unlocked: Is It Your Time to Serve?

The ONS Podcast

“If you are considering board service, I would say take the leap. Start with your local chapter. It will give you some valuable skills that will help prepare you when you are applying for your national level. And I always say, if you want to do it, just do it because what’s the worst that can happen? They can say no, but that doesn’t mean that you will never serve on a board. I always tell people delayed is not denied,” Cassandra Green, DNP, RN, OCN®, ONS member and past president of the Oncology Nursing Certification Corporation (ONCC) Board of Directors, told Evelyn Wempe, DNP,...

Episode 429: Radiation Site-Specific Side Effects: CNS Cancers

The ONS Podcast

“They’re really worried that radiation is going to be painful. So they come in for that first day of treatment very anxious. With our patients with brain cancer, we’re using the masks on the table, and those masks are very tight and hold their heads very, very still. So they’ll be very worried about being claustrophobic. We may start out the first day or two with a little bit of [lorazepam]. And they’ll come to me and they’ll say, ‘This really hasn’t been as bad as I thought it was going to be,’” ONS member Catherine McCluskey, BSN, RN, OCN®, ROCN™, radiation oncology...

Episode 428: Chronic Lymphocytic Leukemia Treatment Considerations for Oncology Nurses

The ONS Podcast

“Measurable residual disease is where I think the terminology fits best in that, it is intended to measure the amount of cancer cells that are present in the blood or bone marrow at the time the sample was collected. We can identify one cancer cell in a million. Where that can be really valuable is when we start to think about the duration of treatments and the response to some of our treatments,” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical...

Episode 427: Pharmacology 101: Resistance Pathways

The ONS Podcast

“A good way of thinking about this is this is the survival of the fittest clone. There could be a portion of a cancer that naturally has some resistance or ability to survive a particular drug. And over time, as the other cells around it are dying off, that particular clone is able to replicate and continue to survive in the face of that drug therapy and eventually take over as being the fittest clone. At that point, we’re often seeing disease progression,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh,...

Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology

The ONS Podcast

“When people with PTSD [post-traumatic stress disorder] get quite avoidant—and that can be expressed in so many different ways—the implications can be really profound. I think an important invitation to oncologists and oncology nurses and primary care providers who care for people battling cancer is let’s explore what's underneath these avoidant behaviors. Is it a very practical thing? Or is it that underneath this avoidant behavior is really profound fear?” James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Lenise Taylor, MN,...

Episode 425: How AI Can Help Healthcare Organizations Improve the Cancer Experience

The ONS Podcast

“In oncology specifically, where care is complex, artificial intelligence (AI) can really synthesize large volumes of clinical information, flag risks such as treatment complications, and support adherence to evidence-based pathways. For nurses specifically, this enables them more time for direct patient care, clinical judgment, and care coordination, and really practice to the top of their license while reducing repetitive time and administrative tasks,” Jenn Frith, DNP, RN, OCN®, NE-BC, associate vice president of clinical operations at Duke Cancer Institute in Durham, NC, told Jaime...

Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis

The ONS Podcast

“Think about what organs lie in the radiation field, and anything that lies in that radiation field is likely going to have some potential temporary—hopefully temporary—side effects. If you think about the pelvis, the things that live in there are the bladder, urethra, some bowel, rectum, reproductive organs, skin, some lymph nodes. And so, all of those things could potentially have associated side effects,” ONS member Kayla Kafka-Peterson, BSN, RN, ROCN™, nurse navigator and leader in the brachytherapy and peri-anesthesia programs at UCLA Health, in Los Angeles, CA, told Lenise...

Episode 423: Pharmacology 101: Interaction Pathways

The ONS Podcast

“When we think of drug interactions, specifically, the National Cancer Institute actually defines this as a change in the way a drug acts in the body when taken with certain other drugs, herbals, or foods or when taken with certain medical conditions. Drug interactions may cause the drug to either be more or less effective or cause effects on the body that are not expected,” 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...

More Episodes

“Our goal of precision oncology has been to shift to tailored therapies that can help to improve treatment efficacy and ultimately improve patient outcomes. Resistance biomarker testing can help the care team to detect these genomic changes that the tumor may have acquired during therapy that makes the cells resistant to therapy. This information can be extremely helpful when we’re talking about making choices about second-line or subsequent-line therapy,” ONS member Danielle Fournier, DNP, APRN, AGPCNP-BC, AOCNP^®, advanced practice RN at the University of Texas MD Anderson Cancer Center in Houston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about drug resistance biomarker testing.

This podcast episode is sponsored by AstraZeneca. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Episode Notes

This episode is not eligible for NCPD credit.
ONS Podcast™ episodes:

ONS Voice articles:

ONS Biomarker Database
Clinical Journal of Oncology Nursing article: Tumor-Agnostic Therapies Reshaping Cancer Care
ONS book: Understanding Genomic and Hereditary Cancer Risk: A Handbook for Oncology Nurses
ONS course: Genomic Foundations for Precision Oncology
ONS Genomics and Precision Oncology Learning Library
American Cancer Society Cancer Action Network:

Find out which states are currently discussing biomarker testing bills and how you can advocate for them through ONS.

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

“We know that biomarkers are playing an ever more important role in cancer care, and really, their use can range anywhere from helping us to confirm a given diagnosis, understand a patient’s cancer susceptibility or risk, evaluate prognosis, as well as personalize treatment recommendations. … But in some cases, though, biomarkers can also help us to avoid therapies that are not likely to work. We also call these drug resistance biomarkers. These are those biomarkers that signify that a tumor is unlikely to respond to a given therapy.” TS 1:50

“Resistance to cancer therapies is one of the most common issues that arises during cancer treatment. Because the populations of cancer cells within a tumor can be very diverse, when a given drug kills the cells that are sensitive to that therapy, it can also eventually leave behind resistant tumor cells, which can grow and multiply over time. So this can ultimately lead to a point where the treatment that was initially effective is no longer able to control the disease.” TS 4:33

“While costs have come down, there can still be a cost associated with biomarker testing, and in some cases, this can be considered a barrier to care. What patients pay out of pocket can vary widely depending on their insurance coverage. So we have some data that was published from the American Cancer Society Cancer Action Network, and this was published a few years ago in 2023, which showed the average allowed unit cost to insurers per biomarker test ranged anywhere from about $79 for patients who were on Medicaid to about $224 for large-group, self-insured patients.” TS 10:03

“There’s research underway that’s looking not only at genomic changes—so DNA changes that impact drug resistance—but how other substances such as RNA and proteins within the cell can also contribute to drug resistance. And this kind of falls into not just genomics but multiomics field. I have no doubt whatsoever that the use of artificial intelligence and machine learning is likely going to play a large role in drug resistance research. And really, these tools can help researchers to analyze complex data sets, identify novel resistance biomarkers, predict resistance patterns, as well as help to develop treatments that may overcome some of those resistance mechanisms.” TS 17:00

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