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Guidance for the Treatment of Uro-oncology Patients

Objective: To provide guidelines for the treatment of Uro-oncology patients.

The following are some of the measures to be taken for the treatment of uro-oncology patients during coronavirus disease of 2019 (COVID-19):

  1. Stable patients on oral therapy (e.g. Abiraterone / Enzalutamide) should be given 3-month supply. However, the stable patients on docetaxel need not to be checked in clinic every cycle. Two cycles can be confirmed on chemo care at a time.
  2. Adherence to a 3-weekly schedule may not be possible for patients already on docetaxel chemotherapy (CT). So, treatment gaps or less frequent administration (e.g.4 or 5 weekly) is advised.
  3. Granulocyte-colony stimulating factor should be added in all CT.
  4. Prioritization for CT cancellation for prostate cancer patients should be as follows:
  • Low priority- should be for hormone sensitive prostate cancer patients already on CT and castration resistant and hormone sensitive prostate cancer patients who are yet to start CT.
  • Medium priority- should be for patients enrolled in clinical trial and castration resistant prostate cancer patients who are already on CT.
  • High priority (other genitourinary cancer patients) - should be for patients undergoing testicular germ cell CT and neo-adjuvant bladder CT. For bladder immunotherapy in responding patients or new programmed death-ligand 1 positive patients.

References: Alonzi, R., Antoniou, G., Anyamene, N., et al. Guidance for treatment of uro-oncology patients during COVID-19 pandemic. Available from: https://www.rcr.ac.uk/sites/default/files/prostate-cancer-treatment-covid19.pdf. Accessed on May 7, 2020