Gene therapy: current and future implications for oncology nursing practice

Breakthroughs in cancer gene therapy

OBJECTIVES

To give oncology nurses an overview on the vectors and selected approaches used in the current clinical trials involving gene transfer to cancer patients.

DATA SOURCES

Peer-reviewed scientific papers, review articles, and book chapters.

CONCLUSION

Significant progress has been made in the field of cancer gene therapy. Different phases of clinical protocols derived from new generations of vectors and novel approaches are being tested for use in the treatment of patients with cancer.

IMPLICATIONS FOR NURSING PRACTICE

Oncology nurses need to be familiar with current advances in the field of cancer gene therapy to expand their role as health care professional, patient educator, and advocate for the treatment of patients with cancer.

The role of oncology nurses in gene therapy

In February 2001, the Human Genome Project international consortium announced the publication of a draft sequence and initial analysis of the human genome. Although a definitive count of human genes must await further experimental and computational analysis, scientists now estimate that the human genome contains 30000-35000 genes--a much smaller number than initially estimated. The advances in treatment which will result from this research and our improved understanding of cancer at a molecular level will rapidly change the management of cancer. Gene therapy represents one new approach to treatment, but is currently still experimental. This article reviews the important role of the oncology nurse as a member of the multidisciplinary team caring for patients who receive gene therapy as part of a clinical trial.

Adenovirus in cancer therapy: a gastrointestinal case study

Approved clinical trials involving gene therapy have been taking place for less than 10 years. As more knowledge is gained about genetics and disease, nurses must have a fundamental understanding of what genes do, how gene therapy is administered, and the risks and potential benefits of treatment. New methods for the administration of adenoviral vectors for cancer treatment in the endoscopy lab are currently being developed. By staying abreast of new treatment methods using gene or viral therapy, the gastrointestinal nurse can actively participate in clinical trials. A basic background of genetics and gene therapy in cancer is discussed. Safety issues and nursing implications regarding the administration and recovery of patients following gene therapy in the GI endoscopy lab are also addressed. An actual case study of a patient who participated in a study utilizing an attenuated adenovirus as investigational therapy for pancreatic adenocarcinoma is presented.

Genetics in the OR--implications for perioperative nursing practice

New developments in deoxyribonucleic acid (DNA) technology are increasing understanding of the role of genetics in health and disease. This kind of health information requires that perioperative nurses develop new skills and roles that will enhance the quality of genetic health care they provide to patients, particularly with regard to managing genetic information. Perioperative nurses expand their scope of practice to incorporate a genetic focus into health assessment, patient education, and patient support as they assimilate new genetic information into their daily lives. Perioperative nurses familiar with genetic counseling services--and how and when to refer patients for such services--will ensure that all patients have access to the most current and appropriate genetic information with which to make informed health choices.