Published on November 3, 2015
In this “Ask the Expert” segment featuring Dr. Kim-Hien T. Dao from OHSU Knight Cancer Institute, she responds to Kent’s question, “Is it possible to take a drug holiday, and if so for how long?” Dr. Dao explains how she would approach this situation for patients, specifically, why the patient would want a break from treatment.
Transcript | Can I Take an MPN Treatment Holiday?
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Kent wrote in with this question. He says, “I've been on hydroxyurea (Hydrea) for several years. Is it possible to take a drug holiday, and if so for how long? And how frequently should I see my doctor?”
Yes. I think this question does come up with patients. The question is why do they want a hydroxyurea holiday? Is it because they have some symptoms that are not controlled or a side effect of hydroxyurea. Do they have ulcers? Do they have night sweats that are bothersome? So I think getting to the bottom of why the patient is asking this question is important because that may, you know, change your treatment plan for this patient.
Taking a hydroxyurea holiday is feasible, but, you know, recognizing that the drug has a very short, you know, effect. So within a week you might start to see some of the issues of high hematocrit, high platelet or high white count come up. So these patients should be monitored very closely, initially maybe weekly. And then if they restart the drug, then also monitoring that, you know, reinitiation closely as well. So there are ways to give them a brief holiday, but we have to understand why and then maybe make a treatment plan that makes sense.
Sound like you're not a big fan of it if the drug's working.
I think if it's working and the patient well tolerates, I think it's a really good drug as a first line for PV patients to give them that extra hematocrit control as long as there [are] no side effects that are untoward for the patients.