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CLL Support Association
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Ibrutinib interruption for surgery

Does anyone know if there have been any studies on the effect that interrupting ibrutinib for surgery has on progression free survival after the ibrutinib is resumed?

john

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No, not that I'm aware of... but there are mentions of disease progression after withold in some of the early work... not sure of the time frame... 3-7 days seems to ring a bell... per and post surgery...

My protocol mentioned it...

cancercare.on.ca/CCO_DrugFo...

~chris

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Thanks Chris, Do you mean disease progression after withholding, but before restarting?

john

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I faced this a year ago prior to colon surgery and Imbruvica (ibrutinib) can be paused without progression... for about 2 weeks... as I understand it.

I my case it wasn't a problem... I quit ibrutinib due to other side effects 8 weeks prior to surgery... it was only blood thinners I had to deal with and pause, and that was fine...

~chris

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There is data out there and it is not recommended to stop the drug.

The data is very new and some not even officially published, with a videoed discussion between two CLL specialist doctors.

If you go to this Patient Power video at this link below and go to the period starting at 19.00 minutes you will get expert information from Dr George Follows from the UK and Dr Jeff Sharman from Oregon USA, discussing this exact question. These doctors are two leading specialists in CLL, and their expertise is without question.

patientpower.info/video/ash...

Frankly the whole video is well worth a watch and there is good, important and up to date, information.

Dick

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John,

I am also interested in the replies. I'm also on Ibrutinib & been told I'd have to go off it 7 days prior & 7 days post any surgery due to the bleeding risk.

BTW - do you bruise and/or bleed easily now?

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I'm not on Ibrutinib yet, but wonder if I should look into getting some elective surgery done before I start.

john

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Probably advisable... generally elective surgery should be done as early as possible post CLL diagnosis.

Most treatments can effect surgery decisions one way or another, higher risk of infections, low platelet counts, poor overall immune system and so on...

Not always possible of course...

~chris

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Hi John, I've been on Ibrutinib for a little over three years and doing well on it. A week before Christmas my oncologist stopped it for a week to see if the irregular heartbeats I was having would stop, and for me to see a cardiologist in the meantime. Within four days my lymph nodes swelled up and I developed a very high fever (39.8) which landed me in the Chelsea and Westminster hospital for theee days on IV antibiotics. My neutrophil count had been low at the time (0.8). I've now been asked to resume taking Ibrutinib in a reduced dose and I'm better again.

I know others have been fine on stopping Ibrutinib, so perhaps it works differently for everybody.

Naana

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I'd be interested too as having surgery on 19/01/17, have to stop ibrutinib on 12/01 for 14 days, Terry

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Interesting discussion. I had to stop ibrutinib 3 days prior to a kyphoplasty procedure, which is much less invasive than surgery. Total time off was 7 days and just started back up 2 days ago. Dr. Weirda mentioned that it would probably take a month or so before my WBC started to climb back up off the medication. I did experience returning night sweats after only 4 days without ibrutinib. It is probably like many other things with CLL, in that we all have different reactions.

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