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The ONS PodcastAuthor: Oncology Nursing Society
Where ONS Voices Talk Cancer Join oncology nurses on the Oncology Nursing Society's award-winning podcast as they sit down to discuss the topics important to nursing practice and treating patients with cancer. ISSN 2998-2308 Language: en Genres: Education, Health & Fitness, Medicine Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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Episode 439: Cancer Therapy for Noncancer Indications: Gene Therapies
Episode 439
Friday, 30 October, 2026
"With the gene therapy itself, we collect the patient's own hematopoietic stem cells and modify them outside the body. The other approach is using a lentiviral therapy, which uses an inactivated virus to add a healthy gene, so the cells produce functional hemoglobin. While gene therapy looks a lot like an autologous stem cell transplant, the key difference is that the cells are genetically modified before they're returned to the patient," Tia T. Wheatley, DNP, RN, AGACNP-BC, TCTCN™, nurse practitioner in hematology and oncology at UCLA Health in Los Angeles, CA, told Madeline Johnston, MSN, RN, OCN®, oncology clinical specialist at ONS, during a conversation about gene therapies for sickle cell disease. Johnston also spoke to ONS member Michelle Cha, MS, BSN, RN, clinical research nurse at the Centers for Bleeding Disorders at Georgetown University Medical Center in Washington, DC, about gene therapy for hemophilia. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 30, 2027. Michelle Cha reported financial relationships with HemaBiologics, Sanofi, Acumetis Global, and Bayer, as well as research funding from multiple organizations. These financial relationships have been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to gene therapy for noncancer indications. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 433: Cancer Treatments for Noncancer Indications: Chemotherapy/Immunotherapy Episode 416: Cancer Treatments for Noncancer Indications: Radiation Episode 288: Pharmacology 101: Antimetabolites Episode 286: Pharmacology 101: Alkylating Agents Episode 208: How to Have Fertility Preservation Conversations With Your Patients Episode 173: Oncology Nurses' Role in Stem Cell Transplants for Pediatric Sickle Cell Disease ONS Voice articles: Adherence to Recommended Oral Hygiene Can Help Prevent Oral Mucositis in Patients With Cancer FDA Approves First Adenoviral Vector-Based Gene Therapy for High-Risk, BCG Unresponsive, Non–Muscle-Invasive Bladder Cancer Fertility Preservation Protects Possibilities for Patients With Cancer New NIH Program Aims to Increase Gene Therapies for Rare Diseases Photobiomodulation Shines a New Light on Oral Mucositis Care ONS book: Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition) ONS course: ONS Hematopoietic Stem Cell Transplantation™ Clinical Journal of Oncology Nursing articles: Gene Therapy for Sickle Cell Disease: No Donor, No Problem Role of the Nurse Coordinator in Hemophilia Gene Therapy ONS Huddle Cards: Alkylating Agents Antimetabolites Fertility Preservation Financial Toxicity Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Wheatley: "When we talk about the evaluation process prior to the therapy, it's very similar in ways to an autologous stem cell transplant evaluation. We still assess things like heart function, liver function, lung and kidney function, along with considering the patient's sickle cell history, their infectious disease status, and their overall health going into it. I think two areas that are especially important during this time are discussions of fertility preservation and financial clearance. These patients will receive myeloablative chemotherapy, so reproductive risk needs to be evaluated and discussed early in the process. And because these treatments are extremely resource intensive, insurance coverage and financial resources need to be addressed before treatment begins." TS 3:43 Wheatley: "The actual infusion itself is very similar to what we're used to in transplant nursing when giving cryopreserved stem cells. In this case, though, we want to be very mindful that patient product verification is done. This is an absolutely critical step for patient safety because we've manufactured a product specifically for that patient. The infusion process itself—nurses and stem cell techs go through a very extensive process to ensure that the patient's identity matches their product before it's even thawed and infused. So that way, patients don't receive the wrong manufactured product." TS 10:26 Wheatley: "I think hair loss deserves particular attention because it can have significant personal and cultural meaning for some patients. I, myself, am a biracial woman with Black heritage, and I'm particularly sensitive to what this topic can mean for some patients of color. But I also think it's important that we as clinicians don't make assumptions. Having that conversation up front and asking patients what hair loss means to them, what concerns they may have, and discussing that possibility of alopecia early can help patients anticipate this change and can help reduce distress when it occurs." TS 18:48 Cha: "Hemophilia gene therapy uses an adeno-associated virus, or AAV, as a vector to deliver a non-hemophilia gene to the liver. The vector will target hepatic tissue in the liver, and the goal is that it will allow the body to start producing its own clotting factor, because in hemophilia someone will have a deficiency in circulating clotting factor. For hemophilia A that would be factor VIII, and for hemophilia B that would be factor IX. The goal is to increase endogenous clotting factor production, and that would reduce or potentially eliminate the need for routine clotting factor infusions, which some people may need to do based on the severity of their hemophilia." TS 21:54 Cha: "Access is a very important part of gene therapy because it is a very high-cost therapy. I believe the literature estimates that it cost approximately $2.9 million per patient. So insurance coverage kind of becomes extremely significant on whether or not someone can access this treatment. … I also think it's really important to acknowledge that there is a degree of privilege involved with accessing a high-cost therapy. So having appropriate insurance coverage and financial resources can influence someone and whether they're able to obtain treatment." TS 25:11 Cha: "I think the nurse coordinator plays a role across the entire treatment paradigm, regardless of the outcome and regardless of what the patient ends up deciding, whether they decide that gene therapy is for them or not. They, in the short term, will help coordinate a lot of treatment, follow-up insurance and access, identifying resources, and making sure that patients have the support and even transportation to infusion and follow-up appointments. Nurses can definitely help navigate that, as well as working with the social worker, who is also a part of the hemophilia treatment center." TS 34:15
