Episode 437: Precision Oncology: What We’ve Learned and What’s Ahead
The ONS Podcast
“Biomarker testing isn’t just about generating more information. It’s about answering very practical questions for our patients. Can we identify disease earlier? Can we understand whether treatment is working? Are we able to identify why a cancer has become resistant? Ultimately, I think that’s where precision oncology becomes very meaningful. It’s not about the molecular report sitting in the chart. It’s about taking that information and using it to make the best possible decision for our individual patients,” ONS member Erica Bello Rodriguez, MSN, AGNP, NP-C, AOCNP®, oncology...
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Episode 436: Oncologic Emergencies 101: Hypersensitivity Reactions
The ONS Podcast
“The most important thing related to hypersensitivity reactions is that there is often a potential for rapid progression, and that’s what makes these reactions an oncologic emergency. The patients may have symptoms that are mild, and that quickly can progress to respiratory compromise, hypertension, cardiovascular issues, or anaphylaxis. Early recognition is so important, so we don’t want to wait for our patient to become hypotensive or significantly hypoxic before we identify that they’re having a serious reaction,” ONS member Christina Matousek, DNP, RN, OCN®, patient education...
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Episode 435: An Overview of Hodgkin Lymphoma for Oncology Nurses
The ONS Podcast
“The accumulation of these malignant and reactive cells, that’s what causes the lymph nodes to get big. That’s why they grow. And that’s why the classic presentation is persistent, painless, enlarged lymph nodes. So when we think of the pathophysiology of Hodgkin lymphoma, there are really two processes contributing to the presentation: One is the physical effects of enlarging lymph nodes or the involved organs. The second is the systemic inflammatory response generated by it and its surrounding immune environment,” ONS member Victoria Krogg, DNP, APRN-CNP, AOCNP®, nurse...
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Episode 434: Oncology–Psychiatric RN Collaboration to Support Psychosocial Health
The ONS Podcast
“Nurses are the front line. Oncology nurses see their patients almost all day. If you’re noticing that anxiety is causing significant distress or anxiety is disrupting a patient’s ability to concentrate during medical conversations or decision-making—anytime you’re seeing significant distress or disruption to functioning, that’s a pretty good indicator that referral to a psychiatric nurse and psychiatric care could be very helpful for that patient,” Amber Altidor, DNP, APRN-FPA, PMHNP-BC, assistant professor at Rush University College of Nursing and psychiatric nurse practitioner...
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Episode 433: Cancer Treatments for Noncancer Indications: Chemotherapy/Immunotherapy
The ONS Podcast
“Unlike our cancer indications where we use these medications often to activate the immune system to target cancerous cells, in noncancer indications, the goal is really to either suppress an overactive immune or inflammatory cells or modulate the immune system. Immune modulation by use of chemotherapy and immunotherapy can help reduce abnormal inflammation, decrease autoantibody production, and also can alter T-cell and B-cell activity,” ONS member Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA,...
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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...
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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....
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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,...
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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...
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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...
info_outline“There are a lot of specifics that nurses need to keep in mind as they are administering this herpes simplex modified virus to patients because accidental exposure is of concern both to the patient, to their family members, as well as to healthcare workers. I always recommend nurses wear personal protective equipment, such as a gown, safety glasses, gloves, and/or a face shield,” Heidi Finnes, PharmD, RPh, BCOP, director of clinical ambulatory practice at Mayo Clinic and assistant professor of pharmacy at Mayo Clinic Alix School of Medicine in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about oncolytic viral therapy.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 29, 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 about the use of oncolytic viruses to treat cancer.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- ONS Voice articles:
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum article: Administration and Handling of Talimogene Laherparepvec: An Intralesional Oncolytic Immunotherapy for Melanoma
- ONS book: Guide to Cancer Immunotherapy (second edition)
- ONS clinical practice resource: Safe Handling of Oncolytic Viruses
- ONS Huddle Card: Immunotherapy
- Association of Community Cancer Centers (ACCC)
- Drugs@FDA
- Hematology/Oncology Pharmacy Association (HOPA)
- Network for Collaborative Oncology Development and Advancement (NCODA)
- Patient Education Sheets
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Highlights From This Episode
“[Oncolytic viruses] can have direct lysis to the tumor cells themselves, or they can cause immunogenic activation. They release tumor-associated antigens and then proinflammatory signals, so think of T cells, natural killer cells, those sorts of things, that can convert to immunologically cold tumors. Those are tumors that are immune silenced into hot tumors which are now immune activated. By doing that, they recruit those T cells and other cells to the area to attack both the primary tumors. But that’s also thought to be how they work on distant or noninjected sites as well. This immunomodulatory capacity has led to the reclassification of oncolytic viruses as a form of cancer immunotherapy. So, think of it kind of similarly to how we think of immune checkpoint inhibitors in recruiting immune cells and leaving our immune system in the on position. This is also kind of a form of immunotherapy.” TS 4:35
“One of the toxicities I know that is of significant concern to patients, family members, and healthcare workers is the incidence of herpes infections. Systemic herpetic infections are extremely rare and usually more common in patients who may be immunocompromised. In patients who also have other immune-related diseases—such as vitiligo, vasculitis, pneumonitis, sometimes worsening psoriasis—because you’re mounting an immune response with these types of things, sometimes you can see a worsening of those types of immune symptoms. But for the most part, these types of side effects are very well tolerated in most patients.” TS 9:07
“Talimogene is generally transmitted via bodily fluids or touch. It’s not airborne. Herpes simplex virus isn’t an airborne type of virus. Another thing to consider is where are you going to inject this? Are you going to do this in your infusion therapy unit? Are you going to do it in a dedicated room? Who’s going to escort the patient to the room? How is the virus going to arrive at the room? How will you clean the room and all of the laboratory equipment or any of the exam tables that may be in there? I think having all of that discussed and assigned mitigates the consternation that can sometimes occur—the fear that occurs with administering a virus that is thought to be fairly communicable.” TS 15:44
“Helping patients understand how this works [is important] because hearing that you’re receiving a virus, particularly a herpes simplex virus, can be scary to a patient. I think understanding that it’s modified or essentially we’re taking the parts out of it so that we can directly inject a portion that recruits immune cells to that area, because the goal is for the oncolytic virus to attack cancer cells and then destroy them by triggering an immune response in the body.” TS 20:51
“Sometimes patients are very concerned about urine in the toilet, bodily fluids, kissing loved ones, holding hands, hugging, you know, am I going to infect my loved one because I’m getting this type of an oncolytic virus therapy? I like to reassure patients that they can continue to hold hands and hug their loved ones as normal. Viral DNA is usually only present on the injection site. And as I mentioned previously, we want to cover that injection site with an occlusive dressing, at least with talimogene, for up to seven days. And particularly, if those injection sites are at all oozing or weeping, active virus is usually only on that injection site itself.” TS 24:14