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Systemic Therapy Considerations:

Risks and Resource Utilization cont.

Treatment Considerations

Bone-targeted • Encourage self-injection where possible 1
supportive therapies • Consider frequency of laboratory monitoring 1

• Temporarily discontinue therapy if laboratory monitoring is not possible 1
• Consider longer treatment intervals ;
1
eg, extending q 4 weekly denosumab to q 12 weekly 2

• Consider denosumab over zoledronic acid , or deferring therapies such as
2
zoledronic acid 3

Other considerations:
• Drug access via private insurance / occupational instability 3
• Use standard of care protocols vs. compassionate access program 4

1. Kokorovic A, et al. Can Urol Assoc J. 2020 Apr 28. doi: 10.5489/cuaj.6667.
2. Ontario Health – Cancer Care Ontario. COVID-19 Supplemental Clinical Guidance for Patients with Cancer. March 29, 2020.
3. BC Cancer. Provincial Cancer Clinical Management Guidelines in Pandemic Situation (COVID-19). Apr.20, 2020. 20