What are your recommendations for holding bevacizumab before and after SBRT to the lung?
Answer from: Radiation Oncologist at Academic Institution
I would just not use SBRT when bevacizumab has been (or will be) applied. Please see the slides from my ASTRO Lung Highlights last fall, with the discussion of the Wang’s abstract, which reports on very severe toxicity of such combination.
Comments
Medical Oncologist at Boston Med Center What is a safe time frame from administration of S...
Radiation Oncologist at University of Pennsylvania Health System I agree with @Maria Werner-Wasik. I haven't combin...
Radiation Oncologist at Carolina Regional Cancer Center Would you consider SBRT for a small, peripheral ol...
Radiation Oncologist at University of North Carolina Yes, I have. Please see my response to this questi...
Radiation Oncologist at Carolina Regional Cancer Center Thanks!
Answer from: Radiation Oncologist at Academic Institution
There are a few issues that need to be addressed in regard to the use of stereotactic body radiation therapy before and after bevacizumab for thoracic malignancies. I personally do not believe it is an absolute contraindication but it should not be a frequent occurrence and I do not use for central ...
Answer from: Radiation Oncologist at Academic Institution
As @Maria Werner-Wasik notes, our experience at Memorial Sloan Kettering has indicated that giving SBRT for ultra-central lung tumors in a patient who has also been exposed to VEGF inhibitors may be an extremely dangerous combination associated with a high risk of fatal pulmonary hemorrhage. Th...
Answer from: Radiation Oncologist at Academic Institution
Avastin has a LONG half life from 0.5 to 1.5 months.
Most of the reported grade 5 toxicities for central/ultra central SBRT have been bleeding in the context of current/previous Avastin administration. The absolute risk is low, but certainly real enough to give pause. We must be cogniza...
Comments
Radiation Oncologist at Thomas Jefferson University Hospital Remember that you can always treat a tumor with ei...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System Yes, and also compact-field concurrent chemoradiot...
What is a safe time frame from administration of S...
I agree with @Maria Werner-Wasik. I haven't combin...
Would you consider SBRT for a small, peripheral ol...
Yes, I have. Please see my response to this questi...
Thanks!