Katherine Mitchell, APRN, AOCNP

In my practice, I am constantly being asked how to properly treat scalp involvement in relation to these skin toxicities.

I currently have a 77-year-old non-Hodgkin lymphoma patient that recently started bendamustine/rituximab combination therapy. After increasing the intravenous rituximab rate per protocol, she developed chills.

I currently have a 68-year-old patient with EGFR-mutated adenocarcinoma of the lung, who presented with metastatic disease to the brain, liver, and bone in late 2014.

If you’ve been in oncology long enough, you’ve likely seen the patient who presents with metastatic disease, gets first-line therapy, progresses, switches to second-line therapy, progresses again, and so on, with their cancer becoming increasingly more resistant to therapy.

By now we are all familiar with vascular endothelial growth factor (VEGF) and its role in tumor growth. Bevacizumab (Avastin), a well-known VEGF inhibitor, is a monoclonal antibody widely utilized in the treatment of various cancers, often in combination with other chemotherapeutic agents. Bevacizumab works by binding to VEGF receptors on the surface of endothelial cells, thereby blocking angiogenic activity. But now there's a new drug in town: ramucirumab.