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CONTEXT: Tyrosine kinase inhibitors (TKIs) are the standard of care therapy for chronic myeloid leukemia (CML). The current disadvantages of lifelong treatment include adverse effects and financial burden. AIMS: This study aimed to evaluate the outcomes of treatment-free remission (TFR) in CML patients. SETTINGS AND DESIGN: A retrospective cohort study was conducted in our oncology center. SUBJECTS AND METHODS: Patients ≥18 years old diagnosed with CML, received TKI and had a TFR trial to achieve TFR, with at least 6 months follow-up, and who received TKIs were included. Patients with a previous hematopoietic stem cell transplantation were excluded. The primary outcome was the proportion of patients with sustainable TFR at 6 months. The secondary outcomes were the proportion of patients with sustainable TFR at 12 months, the rate of regaining a major molecular response (MMR) after relapse, and the cost-saving impact. Descriptive statistics were used for the demographics and outcomes. RESULTS: A total of 250 patients were screened for eligibility, 25 patients were enrolled. The median age was 54 years (interquartile range: 45.5–59), 60% were female. TFR was 92% at 6 months and 72% at 12 months. 100% of the patients regained MMR. The total number of TFR days were 17,024 which resulted in a direct cost saving of SR 7,205,601.9, based on Saudi FDA pricing. CONCLUSIONS: The study indicated that the majority of the CML patients achieved 6 months TFR. This initiative has resulted in a significant cost saving. Future studies should characterize potential candidates for TKI discontinuation. [ABSTRACT FROM AUTHOR]

Purpose: During COVID-19 pandemic, cancer patients are considered one of the most vulnerable to infection since they tend to have advanced age, multiple comorbidities, and are often immunosuppressed by their cancer or therapy. Hence, the Saudi Oncology Pharmacy Assembly has issued recommendations to reduce the frequency of cancer patients' visits to oncology centers during the pandemic while maintaining the access to cancer therapy and minimize the risk of exposure to coronavirus disease. Materials and methods: A qualitative methodological approach was conducted in April 2020 using a virtual panel discussion for collection of recommendations. Results: A total of 12 expert oncology pharmacy practitioners shared their knowledge and experiences in managing oncology patients during the COVID-19 pandemic. The participants recognized many fundamental recommendations that were already applied in many cancer centers since the start of the COVID-19 outbreak. On that basis, the panelists developed eight practice-related recommendations for action, with a main focus on cancer treatment modification. Conclusions: In conclusion, delivering cancer care during the COVID-19 pandemic carries significant challenges. This paper addressed suggestions to properly manage cancer patients during difficult times. Implementing changes in practice mandates a national collaborative effort from different sectors to guarantee the quality and continuity of care. The SOPA expert panel developed these recommendations, to ultimately contribute in maintaining access to cancer therapy while minimizing the risk of COVID-19 exposure. [ABSTRACT FROM AUTHOR]

Backgroud: Oral medications are commonly prescribed for many cancer patients. Unfortunately, most of them are dispensed without proper counseling about handling practices. We aimed to evaluate the handling, storage, and disposal practices of oral anticancer medications among cancer patients and their caregivers at home., Methods: A cross-sectional questionnaire was filled in by adult cancer patients or caregivers who received oral anticancers and/or visited an outpatient pharmacy over two months., Results: A total of 201 participants were interviewed, 67% were female, and nearly 44% were between 40 and 60 years of age. The majority of participants were educated (78%). The top five medications involved were: tamoxifen, capecitabine, letrozole, dasatinib, and imatinib. More than 95% of participants reported that medications were kept away from children and pets in the original container and stored away from extreme heat, cold, and humidity. Hand washing and wearing gloves were not consistently practiced. Only 5% reported "Always" wearing gloves, while 24% reported "Always" washing hands after handling anticancer medications. The participants reported that they had been informed about safe handling and storage by their physician (39%) and pharmacist (25%), while 34% had not been informed. In terms of disposal practices, 66% of patients have not had any unused or expired medications, 29% disposed them in the trash, and 27% returned them., Conclusions: Our findings suggest that patients and caregivers' handling practices of oral anticancer medications are inconsistent with the published recommendations. Hence, appropriate and comprehensive education is needed to mitigate the risk of exposure to these agents in the home setting.