Is there a risk of increased side effects with combined radiation and ibrutinib therapy?
Would you change your radiation therapy treatment dose or volume if you needed to treat a chloroma? If a patient had a separate cancer (e.g., skin cancer, breast cancer, etc.), would you recommend stopping Imbruvica or trying to avoid RT?
Answer from: Radiation Oncologist at Academic Institution
It is increasingly common to see patients with various hematologic malignancies requiring palliative RT who are on small molecular inhibitors (such as ibrutinib) or other novel agents. There is often a dearth of information in the medical literature regarding the safety of combining RT with these dr...
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Radiation Oncologist at Tri-County Oncology Can you treat the patient with combined chemo and ...
This is a great question and comes up frequently in clinical practice, as patients with CLL are at a higher risk for secondary primary malignancies (SPM). Ibrutinib (or other targeted agents) has not been shown to be a radiosensitizer, so it would be safe to continue ibrutinib while receiving radiot...
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Medical Oncologist at Mayo Clinic Agree with the approach of Dr. @Rhodes. Additional...
Answer from: Radiation Oncologist at Community Practice
There was a similar question posted on this forum recently, only in regards to the safety of venetoclax (Bcl-2 inhibitor) and concurrent RT.
As @Christopher R. Kelsey correctly mentioned, there is yet a paucity of robust data regarding the safety of these and other "novel" oral lymphoma agents when...
Answer from: Radiation Oncologist at Community Practice
When in doubt, due to no or very limited data on concurrent radiotherapy with new drugs, I generally err towards a break from the drug, or if not possible or feasible to take a break, counsel the patient about the uncertainties and possibility of severe side effects.
Be sure to check the eliminatio...
Answer from: Radiation Oncologist at Academic Institution
I have seen cutaneous bleeding in an irradiated area in an older patient who received RT for early-stage breast cancer (26 Gy in 5 fx per FAST-Forward), getting concurrent ibrutinib for CLL. She developed ecchymosis over the entire portal area without obvious trauma. It was not subtle, her entire br...
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Radiation Oncologist at Allentown Radiation Oncology Associates @Puyao C. Li—This might make a good case rep...
Can you treat the patient with combined chemo and ...