Xalkori during WBR - 1260586

tjames
Posts:22

I have been on Xalkori for one year. Recently, I developed a number of mets to the brain, too numerous for gamma knife, for which I will be undergoing WBR. My question is whether I should discontinue Xalkori during the WBR therapy. I have received conflicting comments from the radiation oncologist and my regular oncologist as to whether I should stay on Xalkori during the WBR therapy. The radiation oncologist suggested that because of the "toxic load" it would be best to stay off Xalkori until the WBR is completed. My regular oncologist, however, seems to think staying on it is no problem. Any comments would be appreciated.

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Reply # - November 18, 2013, 09:16 AM

catdander
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Hi tjames, I'm very sorry to know you've developed brain mets. I verdict is probably still out for this.

I'll ask a specialist to comment.

Hope you move through this quickly,
Janine

Reply # - November 18, 2013, 03:54 PM

Dr Laskin
Posts: 34

Dear tjames - i too am sorry to hear about the brain mets. you've asked an excellent question and i'm afraid i don't have a clear answer. there is no data looking at this, to my knowledge at least. it would certainly be a difficult question to study, so we will probably never have a definitive answer.

maybe if it were a bone met then mixing it with radiation wouldn't be risky, but the brain might be more fragile or sensitive in some way. so i think, personally, i would tend to agree with the radiation doctor, after all they are the ones who know most about radiation and the brain.

best of luck!

Reply # - November 18, 2013, 09:41 PM

Dr West
Posts: 4735

I'm sorry to hear about your brain metastases.

Yes, the fact that you've heard so many opinions is a reflection on the absence of any actual data to speak to this question. We do tend to be very cautious about risks when the brain is involved. However, the available data (very limited) suggests that very, very little XALKORI (crizotinib) gets into the central nervous system, so there's good reason to think that it should be safe. Still, there's definitely no standards or recommendations to make, given the absence of any real evidence to answer your question. Instead, we need to just rely on our best judgment.

Good luck.

-Dr. West

Reply # - November 19, 2013, 08:49 AM

tjames
Posts: 22

Thank you, Catdander, Dr. Laskin and Dr. West for your input.

From the input I have received, it is my understanding that if I stop taking Xalkori for 10 days while on WBR the risk of the cancer progressing outside of the brain is fairly insignificant. That being the case, I have decided not to take Xalkori until I'm done with WBR.

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