Nurse Leadership Board NLB Symposium at The IMF’s nurse leaders educate peers

By Diane Moran IMF Senior Vice President, Business Relationship Management

On April 27, the IMF Nurse Leadership Board® (NLB®) members Beth Faiman, Amy Pierre, Tiffany Richards, and Charise Gleason presented the “New and Emerging Therapies for Multiple Myeloma: Case Studies for Nurses” symposium at the 48th Annual Congress of the Oncology Nursing Society (ONS) held in San Antonio, TX.

Founded in 2006 to improve the nursing care and self-care of patients with myeloma, the NLB is a professional partnership that represents oncology nurses who are experts in myeloma at leading medical centers. The annual ONS Congress is the largest conference dedicated to oncology nursing. The NLB has held symposia at ONS for 17 consecutive years. “This long-running NLB symposia series is one of the ways the NLB shares nursing best practices and the latest data that contribute to improved patient care,” said Beth Faiman, who chaired the symposium.

to reducing disparities,” said Amy. “By engaging with and advocating for each patient, we can help each patient achieve their best possible outcome.”

“Henry”

Charise Gleason presented the second case. “Henry was diagnosed with myeloma in 2015 when he was 64. He received treatment with a combination therapy of Revlimid® (lenalidomide) + Velcade® (bortezomib) + dexamethasone (VRd), followed by ASCT and Revlimid maintenance. Unfortunately, Henry’s myeloma began to trend upward in a biochemical relapse in 2020,” said Charise. “For many patients like Henry, their first relapse can be harder psychologically than their initial diagnosis. Patients who experience long remissions begin to think that they won’t ever relapse, so a relapse comes as a huge shock. We are fortunate, however, that there are so many treatment options for patients with relapsed myeloma. Shared decision-making, when patients and providers agree on a treatment plan, is more important than ever with so many treatment options.”

Survivorship care is very important since patients with myeloma are living longer than ever. “We all have some patients who are 20-year survivors of myeloma,” Charise shared. She then cautioned, “Although patients come to rely on their oncology treatment team because they see us often, they should continue to see their primary care doctor for recommended health screenings and preventive care. We [oncology nurses] are laser-focused on their myeloma, while their primary care doctor has a broader view of their overall health.”

“Maria” and “Paul”

“Margaret”

Amy Pierre began the symposia with some background on myeloma and discussed the first case. “‘Margaret’ is 62-year-old woman who, based on initial testing, is diagnosed with smoldering multiple myeloma (SMM),” said Amy. “At the urging of a friend, Margaret sought a second opinion from a myeloma specialist at an academic center. Sensitive bone imaging revealed lesions on her spine and ribs, and Margaret’s diagnosis was updated to active myeloma that needed treatment.”

In the context of the case, Amy discussed disparities: Black Americans have 2–3 times the rate of myeloma and MGUS (a plasma cell disorder that can progress to myeloma) and are twice as likely to die from myeloma when compared to White Americans. Black Americans are less likely to have access to the latest treatments or to have an autologous stem cell transplant (ASCT) or participate in clinical trials. However, research suggests that when treated equally, Black Americans can have equal or better survival possibly because as a group they tend to have less biologically aggressive disease. “Nurses are crucial

Tiffany Richards presented the final two cases of the symposia. “Both Maria and Paul received multiple prior treatments for their myeloma,” said Tiffany. “We are fortunate to have options available to our patients, like CAR T-cell therapy and bispecific antibodies. However, these new therapies come with new potential side effects that nurses need to be knowledgeable about. In addition to managing the potential side effects, nurses are also a main source of patient education, which is important in shared decision-making.”

Tiffany continued, “It is important to refer patients to a CAR T-cell therapy center as soon as it becomes an option to consider for their next treatment, since each center has a process for prescreening patients.” CAR T-cell therapy is currently FDA-approved only for relapsed myeloma.

Tiffany also reviewed bispecific antibodies. “Patients typically receive their ramp-up doses of a bispecific antibody as a hospital inpatient, but after they have received their initial few doses, patients will receive subsequent doses as an outpatient, often from their local provider (if they have completed REMS certification).”