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

Release Date: 03/13/2026

Episode 413: Intrarenal Administration for Upper Urothelial Tract Disease: The Oncology Nurse’s Role

The ONS Podcast

“We thought, from a nursing standpoint, ‘What is our goal for doing this?’ What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we’ve been successful with that. And the third goal is to complete treatment without infection,” ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime...

Episode 412: Pharmacology 101: Cytokines

The ONS Podcast

“They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN,...

Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses

The ONS Podcast

“Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It’s not just people who are anemic that have MDS—it’s different depending on what type of MDS they have. These are averages. We’re giving you statistics based on averages, and you’re an individual, so we want to treat you as an individual,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt...

Episode 410: The Evidence for the Environment’s Impact on Cancer Outcomes

The ONS Podcast

“Cancer and environmental disasters in particular, but the worsening of our environment, are really things that are great equalizers. And we recognize that we’re all kind of in this world together. We can really face these issues on a more human level. I think always recognizing that if we look at something, we think, ‘Well, that doesn’t relate to me or that problem is it really isn’t my problem’—it sure is,” ONS member Margaret “Peggy” Rosenzweig, PhD, CRNP-C, AOCNP®, FAAN, ONS scholar-in-residence and distinguished service professor of nursing and Nancy Glunt Hoffman...

Episode 409: An Overview of Interventional Oncology for Nurses

The ONS Podcast

“Interventional oncology has really evolved into an important component of modern cancer care and is often described now as the fourth pillar alongside medical, surgical, and radiation oncology. The specialty now encompasses a broad spectrum of image-guided procedures that support from cancer diagnosis, treatment, to effectively managing symptoms that are caused by the disease. In other words, what we’re seeing is that across the continuum of care, IO is playing a vital role,” ONS member Evelyn P. Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, executive director for advanced...

Episode 408: Radiation Site-Specific Side Effects: Breast Cancer

The ONS Podcast

“A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It’s quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it’s throbbing or heavy. Clothing may not fit quite right. So we’re always on the lookout for lymphedema,” Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice...

Episode 407: Pharmacology 101: CAR T-Cell Immunotherapy

The ONS Podcast

“You want to try to act quickly and be able to know what the pathways are for appropriate escalating when a patient is having symptoms that are reflective of cytokine release syndrome (CRS) or neurotoxicity. These toxicities are very manageable and treatable when recognized early. To summarize, choosing the right patient, knowing the toxicity profile for each product, and acting early is really what helps to prevent severe outcomes with chimeric antigen receptor (CAR) T-cell therapy,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center at...

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

The ONS Podcast

“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...

Episode 405: Long-Term Multiple Myeloma Considerations for Oncology Nurses

The ONS Podcast

“The disease is increasingly managed as a chronic condition rather than a diagnosis with an immediate terminal outcome. Particularly, with earlier and more effective and sustained treatment options, we can make this disease a very chronic, long-term, livable condition. I want to make sure that patients are aware that this is not a death sentence. This is something that patients can live with for the long term,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®,...

Episode 404: Tailor Patient Treatment Education for Non-Oncology Indications

The ONS Podcast

“We print education sheets that we have, and we say, ‘Just ignore this part that says cancer. You’re getting this med but for a different indication.’ And then you have to really point out what our goals of care are. You’re using the information that, as oncology nurses, we like and love, but we’re having to cross it out and say, ‘Just read this portion and just do this here.’ And that can be challenging for the nurse and probably confusing for the patient,” ONS member Brandy Thornberry, RN, OCN®, outpatient infusion and VAD supervisor at Logan Health in Kalispell, MT,...

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“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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