This module delves into key issues faced by oncology nurses caring for patients with renal cell carcinoma (RCC) who are receiving targeted therapy to treat their disease. The module begins with a general overview covering RCC epidemiology, etiology, clinical presentation, histology, prognostic factors, and treatment options. Whereas surgery is potentially curative for early-stage disease, individuals with advanced RCC have significant treatment needs that are not adequately met by other treatment modalities, such as radiotherapy, chemotherapy, and immunotherapy. To address these unmet needs, intensive research has been devoted to understanding the molecular mechanisms contributing to RCC pathogenesis, particularly the process of angiogenesis, so that rational therapeutic approaches can be developed. Out of these efforts, researchers have developed several therapeutic drugs, including sunitinib, sorafenib, bevacizumab, and temsirolimus, that target various molecular players in the angiogenesis process. Each of the aforementioned targeted agents are reviewed, with detailed information provided on appropriate dosing and administration, major side effects and toxicities, and strategies for managing these complications. I deleted bevacizumab as it is not FDA approved for RCC. In addition, expert recommendations on when and how to integrate targeted agents into the care for RCC patients are provided. The module concludes with several nursing approaches that may be taken with patients on targeted agents to maximize medication adherence and efficacy and minimize adverse effects.





MODULE II
Slide Deck 8 Nursing Considerations With the Use of Targeted Therapy

Nancy P. Moldawer, RN, MSN
Clinical Research Operations Manager
Division of Medical Oncology and Experimental Therapeutics
City of Hope National Medical Center
Duarte, California

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