What is the industry standard for turnaround time of oral chemotherapeutic agents? How soon after the prescription is written should treatment be initiated? Sometimes treatment is initiated very quickly; other times, it seems to take weeks. — Lisa M. Buchanan

Treatment turnaround time with oral chemotherapeutic agents can depend on several factors: (1) type of malignancy; (2) adjuvant, neoadjuvant, or metastatic setting of treatment; (3) concurrent therapies with radiation; (4) drug availability (obtaining the medication and delivery). Initiation of treatment with some oral chemotherapeutic agents can occur relatively quickly if there are no factors delaying treatment such as surgical recovery, performance status, or metabolic factors such as renal or hepatic insufficiency. 

When feasible, standard recommendations are to begin treatment once the drug is made available to the patient without schedule delays. If treatment with oral chemotherapy follows surgery, as with some malignancies such as colorectal or brain tumors, treatment typically starts 4 to 6 weeks after the surgical procedure. When therapy will be concomitant, the oral agent is usually started on the first day of radiation therapy or day 1 of each cycle of intravenous chemotherapy. Other factors that may delay treatment initiation can be related to obtaining the medication through specific specialty pharmacies or patient-assistance programs. — Jiajoyce R. Conway, DNP, CRNP, AOCNP, FNP-BC ONA

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