Oncology Nursing Considerations for Liposomal and Nanoparticle-Based Systemic Therapies in Breast Cancer: A Narrative Review of Patient Assessment, Education, and Toxicity Management

Abstract

Introduction: Liposomal and nanoparticle-based systemic therapies can alter drug solubility, circulation, distribution, infusion requirements, and the pattern or severity of treatment toxicities in breast cancer. These formulation effects can shift where nursing surveillance should be most intensive and how patients should be prepared for treatment at home.

Methods: The review used a clinically focused, purposive synthesis organized around the patient journey and formulation-specific care needs; SANRA domains were used as a self-appraisal framework for narrative-review reporting.

Results: Pegylated liposomal doxorubicin (PLD) and nanoparticle albumin-bound paclitaxel (nab-paclitaxel) provide the clearest formulation-specific nursing examples. With PLD, priorities include infusion tolerance, hand-foot syndrome, mucositis, myelosuppression, fatigue, and anthracycline-related cardiopulmonary vigilance. With nab-paclitaxel, cumulative peripheral neuropathy, functional change, myelosuppression, infection risk, fatigue, and treatment-day tolerance are prominent. Across formulations, high-value nursing actions include documenting a usable baseline, verifying the exact formulation, tracking symptom trajectory and functional interference, teaching formulation-relevant self-care, integrating patient-reported symptoms, and linking warning signs to explicit escalation pathways. Telenursing and digital symptom monitoring are most useful when reported information triggers a defined clinical response.

Conclusion: Nanocarrier-based breast cancer therapy should be approached as a formulation-specific nursing problem. A standardized but flexible pathway connecting baseline risk, treatment-day verification, early toxicity recognition, patient education, serial functional assessment, and timely escalation may improve consistency while preserving regimen- and patient-specific judgment.