medgator

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Did my first case yesterday.

Yes many do although it's sometimes done by nuc med depending on geography and politics
 

Cancerdancer

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We are doing them all in our practice, hasn't even been a conversation about whether us or Nuc Med. There are good consults to see, as I've seen a few with large mets in the proximal femurs that I've run by Ortho and/or done a short course of EBRT while waiting for Xofigo to process/arrive. Same with spine mets, I often throw in 20/5 if bulky/threatening cord. Med Oncs and certainly Nuc Meds don't think about these local issues as we do.
 
Dec 25, 2013
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We are doing them all in our practice, hasn't even been a conversation about whether us or Nuc Med. There are good consults to see, as I've seen a few with large mets in the proximal femurs that I've run by Ortho and/or done a short course of EBRT while waiting for Xofigo to process/arrive. Same with spine mets, I often throw in 20/5 if bulky/threatening cord. Med Oncs and certainly Nuc Meds don't think about these local issues as we do.
That's a very good point and I completely agree.
 

seper

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Dec 22, 2010
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how do you guys figure out use of this drug around chemo regimens?
 

medgator

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how do you guys figure out use of this drug around chemo regimens?
It's pretty straight forward (I think). It's only approved for metastatic castrate-resistant prostate CA with symptomatic bone mets, without evidence of visceral mets (since Xofigo only has a predilection for targeting bone).

If someone presents to me with visceral metastatic disease, I'd send them for chemo (and if their PS isn't great, I believe there is some data now for Zytiga, and soon for Xtandi)