Xofigo with concurrent external beam

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XRT_doc

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Can Xofigo and External beam be given concurrently to a patient?

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Can Xofigo and External beam be given concurrently to a patient?

Would personally not do this outside context of clinical trial (i.e. Phase Ib - dose finding).

Did you look to see if any PhaseIb data for combination available?
Edit- I was wrong here, ebrt was allowed on alsympca
 
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i looked at protocol - you are correct

Ebrt was allowable on protocol per SOC.

But I agree waiting to see effects on hematologic parameters seems prudent.
 
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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..
 
I have seen a couple of cases of transfusion dependent anemia with Xofigo.

I think as long as you are watching counts should be ok
 
Agree with ND. Treat EBRT for pain, or for structural reasons (femurs/spine). If a pt's marrow is so borderline that Xofigo tips them over to needing transfusions, they were headed there anyway. Just be thoughtful and treat only limited volumes with EBRT.
 
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