Is there a risk of increased side effects with combined radiation and ibrutinib therapy?

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...

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...

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 @Dr. First Last correctly mentioned, there is yet a paucity of robust data regarding the safety of these and other "novel" oral lymphoma agents when taken d...

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 elimination...

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...