Training mid-level providers on palliative care: bringing advanced directives and symptom assessment and management to community oncology practices.

Palliative care services are not available in most outpatient oncology practices. A program training 11 mid-level providers from oncology practices on advanced directive discussions and supportive symptom assessment and management performed by palliative care specialists was completed. A follow-up session 9 months later identified barriers to implementation.

Successful administration of panitumumab alone after severe infusion reaction to cetuximab in a patient with metastatic colorectal cancer.

The administration of monoclonal antibodies (MoAbs) can result in infusion reactions of various grades; severe reactions are seen in approximately 3% of patients after infusions of cetuximab (fatalities occur in approximately 0.1% of patients). We report a case of a patient who had a severe reaction to cetuximab (a murine MoAb) who then received panitumumab (a human MoAb) and tolerated it without any infusion reaction.