Xalkori and surgery - 1266691

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Xalkori and surgery - 1266691

So, hubby got his 4 year clear scans! Xalkori for 3 years now. Next on his list is a partial (possibly total) knee replacement that he's been putting off since diagnosis. Are there any precautions with Xalkori and ortho (or any) surgeries?

Hi jmpchic,

Hi jmpchic,

The prescribing information merely states that you should inform your doctor of your XALKORI use prior to surgery. It can interact with other drugs and since it can also lower blood counts and make a patient more susceptible to infection, his doctor may elect to hold it for a short period around the time of surgery.

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Dr West
congratulations on the

congratulations on the favorable scan results!

There is essentially no evidence on the question of holding drug for surgery, and I think the guidance in the package insert just reflects reflexive stock verbiage approved by the company's legal team. There's little to no reason to expect any interaction. I often just have patients hold their oral targeted therapy the day of, or perhaps the day before, a surgery, then resume a couple of days later. Holding it for 2-4 days is almost certainly inconsequential vs. the cancer; it's not clear it's helpful, but I don't think it matters either way. You usually just hold meds and food the day of a surgery (to prevent stomach contents from being aspirated when a person is under anesthesia), and I think that would also be fine.

There's basically no information, and it probably doesn't matter, unless the judgment is to hold the targeted therapy for weeks, which there is no reason to do.

Good luck.

-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education