I have done it several times concurrently with zero reservations (it was allowed on ALSYMPCA).
For those that would wait, are you saying for a patient with bone pain you're going to wait until after the entire 6-month course of Xofigo is complete before offering palliative XRT?
We don't see the hematologic drop with Xofigo that we did with older agents. If your patient is hurting - treat them! Even if your worst fears are realized and their counts drop, you will catch that early enough to transfuse them. But I have not seen that at all personally..