NP Underscores Communication in Managing CDK4/6 Inhibitor AEs in Breast Cancer

It is crucial to communicate potential adverse effects (AEs) associated with CDK4/6 inhibitors to those with breast cancer while also empowering patients to reach out for direction on how to manage their disease, Sarah Donahue, MPH, NP, said in an interview with CancerNetwork®.

Donahue, a nurse practitioner at University of California, San Francisco, and part of the Oncology Nursing Society, spoke to the importance of keeping patients on treatment with CDK4/6 inhibitors by mitigating any toxicity that may occur during treatment. For example, white blood cell count decreases may be combatted by stopping treatment with the agent, she explained.

Transcript:

The main thing that I find most helpful for my patients is to explain the potential [adverse] effects, explain that there’s something that we can do about them, that we can intervene. If they reach out to us sooner, we can help them more. With regard to the CDK4/6 inhibitors, I have a lot of patients who worry that maybe when their white blood cells are low and are on this [treatment] for long-term, they’re thinking, ‘Oh my God, I’m not going to be able to see family or go out in public because I’m going to be neutropenic.’ [It is important to] drive home that the neutropenia that happens with the CDK4/6 inhibitors isn’t something that leads to neutropenic fever or the catastrophic type of issues where they’re having to isolate and everything.

What I tell patients is that, unlike chemotherapy, the CDK4/6 inhibitors are generally not causing problems with the mucous membrane, so that they don’t have that port of entry. All they have is the low white blood cells. All they have to do is stop the medication and it’ll rebound very quickly. [Patients should] wear a mask if they’re neutropenic and, at the time, around people, but they don’t have to avoid family, especially around the holidays.

I hope that the providers who are listening to this now can help to empower their patients to reach out and to ask for advice. That’s the best thing that they can do to keep them on these medications longer. They can work well; we can show that in studies. But if we can’t keep [patients] on the medications, then what are we doing?