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I n t e r n a t i o n a l C o n f e r e n c e o n
Advance Nursing Practice
Journal of Nursing and Health Studies
ISSN 2574-2825
J u n e 2 1 - 2 2 , 2 0 1 8
P a r i s , F r a n c e
Advance Nursing Practice 2018
Page 44
T
he allogeneic graft-versus leukaemia effect was first suggested in 1956
and allogeneic transplant is the original immunotherapy. With the continued
evolution of immunotherapy since 1970s and progressively better understanding
of T cell biology, the treatment paradigms for numerous malignant and non-
malignant diseases have dramatically changed. The understanding of innate and
adaptive immunity, genomic profiling, cellmutations, biomarkers, effector cells, co-
stimulatory molecules, viral vectors and oncogenes, expression of programmed
death genes and checkpoint inhibitors, ongoing clinical trials continue worldwide
as single agents and in combination. Understanding the tumor microenvironment,
tumor-derived factors, and the microbiome also influence the development of
therapeutics. Immune effector cellular therapy also continues to advance with
classicTcell receptors and chimeric antigen receptor Tcells (CART)manufactured
from the patient’s own T cells which are genetically modified, returned to the
patient, and cause an immune response whereby the T cells attack the patient’s
cancer. Many of these therapies will be used in combination, in sequencing, and
with more traditional forms of treatment, such as chemotherapy, radiation therapy,
and hematopoietic cell transplantation. With an aging population and increasing
incidence of cancer, theworkforce demands cannot bemet bymedical oncologists
and hematologists alone. Advanced practice providers (APP) and oncology
nurses will be ideally situated to care for this vulnerable population of patients
who are living longer with the new therapies, but have the potential for substantial
immune-related side effects (irAE) and symptom expression, the potential for
unanticipated autoimmune expression, and the potential for debilitating financial
toxicity. Intensive patient and family education, prompt recognition of irAEs, and
multi-specialty, collaborative approach to patient management will be the key to
safely helping patients on their challenging journeys.
Biography
Robert David Rice is the Director of Nursing Education, Evidence
Based Practice, and Research at City of Hope National Medical
Center in Duarte, CA. He joined City of Hope in July 2013. He
and his staff develop and apply cross-disciplinary education
programs to keep clinical providers current on evidence-based
best practices, clinical techniques, standards, and emerging
technologies unique to their clinical discipline. His clinical
and research interests include hematologic malignancies,
hematopoietic cell transplantation, cancer chemotherapy
/ immunotherapy, immuno-oncology, psycho-oncology,
healthcare disparities, and improving the quality of cancer
care for LGBT patients and families. He participates in national
consortia of comprehensive cancer centers which address
quality initiatives, nurse sensitive indicators (establishing a
national benchmark for the incidence of vesicant chemotherapy
extravasation), and developing a core curriculum to train nurses
in safe chemotherapy administration.
drice@coh.orgImmune effector cell therapies:
considerations for the advanced practice
provider
Robert David Rice
City of Hope National Medical Center, USA
Robert David Rice, J Nurs Health Stud 2018, Volume: 3
DOI: 10.21767/2574-2825-C3-007