Ryan Scott is an Associate Editor of CURE; she joined MJH Life Sciences in 2021. In addition to writing and editing timely news and article coverage, she manages CURE's

social media accounts; check us out @curetoday across platforms such as LinkedIn, Facebook, X, and Instagram! She also attends conferences live and virtually to conduct video interviews and produce written coverage. Email: rscott@mjhlifesciences.

Ryan Scott

Martha Carlson received a diagnosis of metastatic breast cancer in 2015. Read all of 

I know a lot about being a person living with cancer. I’ve been doing it for over 10 years, having started treatment for Stage IV cancer back in January 2015. I’ve had many opportunities to be my own best advocate, sometimes doing it well, sometimes poorly.

Because I have what I call “good patient” tendencies, I have to watch for times like these: not fully understanding what I’m being told but telling myself I’ll “google” it later; realizing I haven’t asked basic questions about the step-by-steps of a procedure; waiting until something gets worse to speak up; not taking up the space and time I deserve in the healthcare setting.

Not a single one of these behaviors leads to satisfaction with care.

My most recent cancer treatment session brought all of this up for me because even though I communicated my concern several times, I ended up with infiltration into the surrounding tissue during an IV of Herceptin. I was lucky it was “just” Herceptin, which isn’t a vesicant drug and unlikely to cause harm (though still possible). If a vesicant drug escapes the vein during treatment, it’s called extravasation and may require extra care to prevent or reduce lasting tissue damage.

I had learned of extravasation while receiving a taxane via IV rather than a port, because my port had to be removed due to clotting. Extravasation doesn’t happen frequently, but it’s important to know the signs of both infiltration or extravasation so that treatment can be stopped and risks reduced.

On this day, when the infiltration happened, I told the chemotherapy nurse that the IV didn’t feel right, but she assured me that there was blood return, plus I could taste the saline when the line started. I didn’t like how the IV placement felt, but my treatment currently takes under an hour, and I figured I could deal with it. Mistake 1: Denying what my senses told me, which was that something was wrong despite the normal signs of a good IV placement and reassurance from the nurse.

When an IV drug infiltrates tissue, two of the first signs can also be things that may occur normally, depending on the drug being given: pain or discomfort at the IV insertion site and coolness. Discomfort at the IV site can also happen for reasons like what vein has been used and even the impact of cold air temperatures or mild dehydration. Coolness at the IV site is a standard feeling for me when getting Herceptin, but I did feel like the site was colder than usual. Mistake 2: I looked at the area around the IV, decided it looked alright, and figured I was having some anxiety, which is also not unusual for me. So, I covered my arm with a blanket to warm it up.

Within a few minutes of this, I looked at the site again because the discomfort there felt a little more intense and saw there was possibly some swelling and the skin was paler. Swelling at the site and paler skin are additional indications of infiltration and extravasation. I called my treatment nurse over and told her, again, that something was wrong with the IV. She looked at it, reassured me again that it was fine, and turned to another patient. Mistake 3: I was certain there was infiltration, but I brushed it off in that moment.

Having told the nurse twice that I thought there was something wrong, I waited another 30 seconds and again looked under the blanket keeping my arm warm. Now there was clearly defined swelling around the IV. I loudly called for one of my regular treatment nurses.

The Herceptin was stopped, the oncology pharmacy was consulted, the IV was removed, and my arm was bandaged. I was told that there wasn’t much risk but to watch for discoloration and to call immediately if I noticed anything unusual with the site or my arm over the next few days. A new IV was placed in my other arm, this time by my familiar nurse, and everything went back to normal.

But I was left with the knowledge that despite advocating for myself, I still had a bad, could-have-been-worse experience. I knew the signs of infiltration and extravasation; I said something twice to my treatment nurse. Afterward, while finishing treatment with a new IV placed in my other arm, the nurse told me that I should have said something earlier. I replied that I had. Unfortunately, she repeated that admonition as I left. It’s no fun to be gaslit about healthcare, and it’s no fun to speak up and not be heard.

As has happened in the past, I’ll add this experience to my understanding of self-advocacy. A reminder that most of us know our own bodies far better than anyone caring for us. I could have been more forceful, and next time, rightly or wrongly, I expect I will be. Here’s to good care, healthcare providers who listen, and properly placed IVs.

For more news on cancer updates, research and education, don’t forget to 

subscribe to CURE®’s newsletters here.

Articles

Living with cancer for over a decade, the author shares insights on self-advocacy in healthcare settings. Despite being aware of the signs of IV infiltration and extravasation, the author experienced a challenging situation during a Herceptin treatment session. Despite voicing concerns, the author faced dismissive responses from healthcare providers, leading to a potentially harmful situation. This experience underscores the importance of trusting one's instincts and advocating assertively for oneself in medical environments, emphasizing the need for attentive healthcare providers and effective communication.

IV infiltration and extravasation remind this cancer patient of the constant challenges of speaking up and advocating for their own care. 

IV Complications and the Challenge of Being Heard 

Billions of dollars of cancer meds go to waste each year while many patients struggle to afford treatment: © stock.adobe.com.

When a breast cancer patient received her prescription for her oncology medication, she experienced a variety of side effects that made it difficult to continue on that dosage. Her doctor changed her dosage and provided a new prescription, but she was left with a blister pack of tablets she had not taken. Knowing how expensive those medications were, she realized the waste that had just occurred.

Meanwhile, another patient, Anne*, had been undergoing treatment for her breast cancer but was heading towards an unsustainable path: she could not afford the medication she needed to survive and had no other options.

“The doctors said it was very important that I continue to receive treatment… There was concern that if I did not take my medicine, the cancer could come back. [But] my medicine was too difficult to afford. My doctors and I had to fight and wait… I did not have any other option. It was a stressful time.”

This situation reflects a broader, systemic issue in oncology care: there is often so much unused surplus, and yet there is so much need. An estimated $2 billion worth of oncology medication gets wasted every year. Cancer patients regularly have extra medicine from prescription changes, adverse reactions, recovery, or other circumstances.

Most of this surplus is currently going to waste, either being disposed of or remaining in the hands of an individual until it expires. No satisfactory disposal method exists, and compounds from oncology drugs are increasingly found in water sources, including drinking water. These compounds are harmful to the environment and living organisms, and there is no sufficient method to remove the contamination, allowing uncontrolled spread.

Meanwhile, 61% of cancer patients and survivors find it difficult to afford their care. Financial hardship prevents many low-income patients from accessing the medications they need, leading them to cut doses, delay medications, or skip prescriptions entirely. Financial toxicity affects all parts of a patient’s life, beyond just their cancer care.

Fortunately, an alternative exists. SIRUM is a nonprofit expanding healthcare access for families in need by leveraging the $11 billion of surplus medicine wasted every year. Under Good Samaritan drug laws, we help collect unopened, unexpired medications from medicine donors and provide them to patients via a network of community partners. Through our individual donation platform alone, we’ve been able to help patients donate millions of dollars worth of medications, including expensive specialty and oncology drugs.

Donating medicine can be deeply rewarding. Patients are motivated by the opportunity to support others facing similar challenges, and families find solace in being able to donate their loved one’s medications, paying it forward in their memory.

“I can’t describe the pleasure and satisfaction I am getting from being able to pass on this extremely expensive, yet unused medication,” one donor told us.

Just spreading the word about medicine donation programs can make a big difference. The next time you or someone you know has extra cancer meds, visit sirum.org/oncology. You can receive a free shipping label to send your medications to be redistributed to someone in need.

Ultimately, Anne was able to receive her life-sustaining medication through SIRUM’s network.

“To the people who donated this medication, I wish them a life full of blessings. I thank them for their solidarity and I hope God protects them. I am grateful they helped me.”

By doing our part, we not only reduce waste but also bring relief to others during challenging times.

*Editor’s note: The patients name has been changed to anonymize this individual

For more news on cancer updates, research and education, 

don’t forget to subscribe to CURE®’s newsletters here.

The narrative highlights the dual issues of medication waste and financial hardship in oncology care. Annually, $2 billion worth of oncology drugs are wasted, while 61% of cancer patients struggle to afford their treatment. SIRUM, a nonprofit, addresses this by redistributing surplus medications to those in need, leveraging Good Samaritan drug laws. This initiative not only reduces waste but also provides essential medications to financially burdened patients. The program encourages donations, offering a meaningful way for individuals to support others facing similar challenges.

Billions of dollars of cancer meds go to waste each year while many patients struggle to afford treatment; donating surplus medicine helps bridge this gap.

Save Meds, Save Lives: How to Donate Your Extra Cancer Medication 

Kidney Cancer Research Embraces Biology-Driven Precision Approach

 (KCRS), Dr. Ari Hakimi, a surgeon and researcher at Memorial Sloan Kettering Cancer Center, helped lead key discussions on how kidney cancer research is evolving through a more individualized, biology-driven approach.

In an interview at the meeting, Hakimi described how next-generation sequencing has become a routine part of care across many cancer centers in the United States. This widespread adoption has enabled consistent, high-quality tumor profiling that can reveal actionable mutations and biological markers in a patient’s tumor.

“These tools allow us to group patients based on a specific mutation or protein marker,” Hakimi said. “That might allow us to enroll them in trials that we might have not considered beforehand.”

He emphasized that researchers and companies are now working together across institutions to identify these molecular signatures, which in turn helps expand access to precision-based clinical trials. This approach not only refines how patients are treated but also opens opportunities for those who might not have been eligible under traditional trial criteria.

How are researchers learning to target kidney cancer more precisely based on individual biology?

Now that things like next-generation sequencing have become standard of care across many cancer centers in the U.S., there is a sense that we can profile patients rapidly with consistent assays and mechanisms. This allows us to group patients into specific categories based on a particular mutation or protein marker, which might enable us to enroll them in trials that we might not have considered beforehand.

So, there are now ways, and I think there are trials, that are looking across different companies and centers for specific events, and that will allow us to enroll patients who may not have otherwise been able to participate.

Transcript has been edited for clarity and conciseness

Videos

Dr. Ari Hakimi highlighted how tumor profiling and molecular markers are expanding access to precision-based trials for kidney cancer.

Researchers are exploring the use of CAR T-cell therapy in clear cell renal cell carcinoma, a type of kidney cancer: © stock.adobe.com.

Researchers are building on the success of CAR T-cell therapy in blood cancers to explore its use in clear cell renal cell carcinoma, a type of kidney cancer. According to Dr. Wayne A. Marasco, this work has led to the development of a dual-targeting CAR T-cell treatment for advanced disease in patients whose tumors overexpress CAIX and CD70.

, Marasco highlighted the goal of evaluating a dual-targeted, fine-tuned, and immune-restoring CAR T-cell therapy for the treatment of patients with CAIX- and CD70-overexpressing clear cell renal cell carcinoma. He noted that this therapeutic strategy, pending clinical investigation, may be a path toward curing this disease subtype.

Marasco is a professor of Medicine at Brigham and Women’s Hospital and a principal investigator of Cancer Immunology and Virology at Dana-Farber Cancer Institute in Boston, Massachusetts.

Following the established role of CAR T-cell therapy for the management of hematologic malignancies, recent work has investigated the CAR T-cell therapy approach in solid tumors, Marasco explained. For example, the phase 1 COBALT-RCC trial evaluated Yescarta, a novel CD70-targeting CAR T-cell therapy, for the treatment of patients with advanced or refractory clear cell renal cell carcinoma.

Dose-limiting toxicities were not observed, and the disease control rate was 81%, with 1 patient remaining in durable complete response at 3 years. The study included 16 patients at least 18 years of age who weighed at least 42 kg with unresectable or metastatic renal cell carcinoma that had relapsed on or was refractory to standard of care. Patients on the trial were also required to have a Karnofsky performance status of at least 80% and adequate renal, liver, cardiac and pulmonary organ function.

The phase 1 TRAVERSE trial evaluated the CAR T-cell therapy Carvykti for the treatment of patients with advanced or metastatic clear cell renal cell carcinoma following lymphodepletion comprising fludarabine and cyclophosphamide with or without ALLO-647. Early data from the study demonstrated that among 44 patients, the overall response rate was 20% in patients treated with the lymphodepletion regimen (6 patients) who had CD70-positive tumors. Treatment-emergent side effects occurred in 96% of patients, with grade 3 or higher side effects observed in 84% of patients. Patients included on the study were at least 18 years of age with advanced clear cell renal cell carcinoma, an ECOG performance status of 0 or 1 and disease progression following immune checkpoint inhibition and VEGF-targeted therapy.

“What’s different about what we’re trying to do here is our target,” Marasco said in reference to the study of CAIX/CD70-directed CAR T-cell therapy in renal cell carcinoma. “Our CAR T cells are dual-targeted and the affinity is fine-tuned to improve safety. We do immune-restoring capabilities at the tumor site to change the tumor microenvironment.”

Specifically, the dual-targeting aspect of the CAIX/CD70-directed CAR T-cell product aims to improve efficacy, whereas the fine-tuned aspect aims to improve safety by targeting only high-density antigen expressed on the tumor cells without targeting low-density antigen on healthy tissues. Moreover, the immune-restoring aspect changes the tumor microenvironment by locally secreting checkpoint blockade inhibitors to restore antitumor immunity.

Preclinical Efficacy and Safety of CAR T-Cell Therapy in Clear Cell Renal Cell Carcinoma

Early efficacy data from a preclinical study demonstrated that CD70 is not universally expressed on renal cell carcinoma cells, and therefore, some targets were CD70-negative, Marasco explained.

“[However,] all tumors express CAIX, which is still the molecule that is most desirable. The killing data in the immunofluorescence analysis show the specificity of the dual-targeted CAR T-cell therapy for both targets. In humanized animal studies, the CAR T-cell therapy effectively cured the animals from the tumors, and in these animals, we don’t even see the tumors after the therapy,” he said.

Although preliminary efficacy data have shown promise, safety data have been the most significant concern, notably due to CAIX overexpression, Marasco added.

“We spent over a decade working this out to be able to develop high-avidity, low-affinity antibodies as the targeting moiety. Why would you want that? Well, we certainly don’t want to target CAIX if it’s in limited quantities, because a high-affinity targeting residue will bind to it,” he said. “You want only targeting molecules that are recognized with high density, and that’s what we engineered.”

Most notably, the immune-restoring aspect of this therapy is “the most important part of this change in the tumor microenvironment,” according to Marasco.

“If we administer CAR T-cell therapy without delivering a payload to the tumor site, we do not ever cure the animals of tumors,” Marasco emphasized. “If we deliver monoclonal antibodies at the tumor sites, which is what we’re doing, we secrete antibodies and checkpoint blockade inhibitors locally at the tumor site, and we can get complete cures.”

Future Steps for Examining CAR T-Cell Therapy in

The investigational dual-targeted CAR T-cell therapy in development by Marasco and colleagues targets CAIX and CD70 and delivers an anti–PD-1 and -CTLA4 bispecific antibody at the tumor site, Marasco reported. Currently, ongoing preclinical studies with this product are nearing finishing stages, which will guide the next step of GMP manufacturing and subsequently submitting an investigational new drug application to the FDA, he explained.

“We’re on schedule to be able to complete this preclinical research and file an investigational new drug application sometime, hopefully in September or October 2025,” Marasco concluded.

“Redesigning CAR T cells for solid tumors: a new path toward cures of ccRCC,” by Dr. Wayne A. Marasco. Presented at: 2025 Kidney Cancer Research Summit; July 17-18, 2025; Boston, MA.

“CD70-targeted allogeneic CAR T-cell therapy for advanced clear cell renal cell carcinoma,” by Dr. Sumanta K Pal. 

A safety and efficacy study evaluating CTX130 in subjects with relapsed or refractory renal cell carcinoma (COBALT-RCC). ClinicalTrials.gov. Updated January 8, 2025. Accessed July 17, 2025.

“ALLO-316 in advanced clear cell renal cell carcinoma (ccRCC): updated results from the phase 1 TRAVERSE study,” by Dr. Samer A. Srour. 

Researchers are advancing CAR T-cell therapy from blood cancers to clear cell renal cell carcinoma, focusing on dual-targeting CAIX and CD70. This approach aims to enhance efficacy and safety by fine-tuning antigen targeting and restoring antitumor immunity. Early trials, such as COBALT-RCC and TRAVERSE, show promising disease control rates and manageable toxicities. Preclinical studies highlight the potential of dual-targeted CAR T-cells to cure tumors in animal models. Ongoing research is progressing towards clinical trials, with an investigational new drug application anticipated by late 2025.

Researchers are building on the success of CAR T therapy in blood cancers to explore its use in clear cell renal cell carcinoma, a type of kidney cancer.

Ryan Scott

IV Complications and the Challenge of Being Heard

Save Meds, Save Lives: How to Donate Your Extra Cancer Medication

Kidney Cancer Research Embraces Biology-Driven Precision Approach

Dual-Targeting CAR T Therapy Shows Potential in Advanced Kidney Cancer

Latest News