About Your Xofigo® Treatment

This information will help you get ready for your Xofigo treatment at MSK.

About Xofigo

Xofigo is a radioactive targeted therapy. It is used to treat prostate cancer that has spread to your bones. It can help prevent symptoms caused by the cancer in your bones.

Xofigo has 2 main parts:

• The tumor-targeted part helps the medicine fight only the tumor cells, not your healthy cells. This helps keep the medicine from harming healthy parts of your body.
• The radioactive part uses radiation (waves of energy) to harm and kill the tumor cells.

You’ll get Xofigo as an intravenous (IV) injection (shot). This is when medicine is put into your vein through an IV line.

Getting ready for your Xofigo treatment

Before you get Xofigo, you’ll meet with a healthcare provider from the Molecular Imaging and Therapy Service (MITS). MITS is sometimes called the Nuclear Medicine service. You may need to have a blood test before your appointment. If you do, a MITS staff member will give you more information.

During your appointment, your MITS provider will review your medical history. Tell them every medicine you’re taking. This includes patches, creams, prescription medicine, and over-the-counter (not prescription) medicine. They will also talk with you about the goals of Xofigo treatment. They’ll use your medical history and the results of the blood test to see if Xofigo is right for you.

Your MITS provider will decide it’s safe for you to start treatment. If it is, then they’ll go over the side effects. They’ll also give you information about your Xofigo treatment schedule.

You may need to stop other treatment for prostate cancer before and during Xofigo treatment. This includes chemotherapy, radiation therapy, or another type of radioactive targeted therapy. If you do, your healthcare provider will give you more information.

Xofigo treatment schedule

The timeline below shows your Xofigo treatment schedule.

You’ll get Xofigo as 6 separate injections. The injections are 4 weeks apart. Your last Xofigo injection will be 20 weeks (about 4 and a half months) after your first injection. You’ll come to MSK for each of your injections.

You’ll also have a blood test 2 to 3 days before each injection. You can have these blood tests done at the MSK location closest to you.

About your Xofigo injection visits

Where to go

Schwartz Cancer Research Building
1250 First Avenue (between East 67^th and 68^th Streets)
New York, NY 10065

Your Xofigo injection visits will be in the MITS therapy suite. To get to the suite:

• Enter the hospital through the entrance at 1250 First Avenue.
• Turn left at the security desk in the lobby. If you have questions or need an elevator instead of the stairs, ask the security guard for help.
• Go up the stairs and check in at the reception desk at the top of the stairs. You can wait in the waiting area.

A staff member will come and bring you to the MITS therapy suite.

What to expect when you arrive

Many staff members will ask you to say and spell your name and birth date. This is for your safety. People with the same or similar names may be having treatment on the same day.

When it’s time for your appointment, a staff member will bring you to the MITS therapy suite.

Radiation safety measures

After your Xofigo injection, there will be radiation coming from your body. A radiation safety staff member will talk with you about your radiation safety precautions before you leave your injection appointment. They will also give you written instructions to follow at home.

• Sit when you use the toilet. Do not use a urinal.
• After you go to the bathroom, flush the toilet and wash your hands well with soap and water.
• If your linens or clothes get stained with blood, urine (pee), or stool (poop), wash them separately from other clothes. Rinse them well.
• Wear medical gloves when handling stained clothes and wiping up blood, urine, stool, and vomit (throw up).

It is safe to be around other people, including pregnant people and children after getting a Xofigo injection. You can spend time near others, hug, hold, and touch them.

Some security equipment, such as at the airport or outside a tunnel, can detect very small amounts of radiation. You will get a card that says you got radioactive medicine. It says you can give off small amounts of radiation for up to 1 month after your treatment. Show this card to law enforcement if they stop you at a checkpoint.

If you have any questions about radiation safety, call 212-639-7391 Monday through Friday from 9 a.m. to 5 p.m.

After your Xofigo injection appointment

Follow the radiation safety instructions. It’s very important to follow these instructions in the bathroom to clean or flush bodily fluids, such as urine.

Drink lots of liquids after each injection. This will help the radiation leave your body more quickly.

Follow these safety instructions during your Xofigo treatment, from your first injection until 6 months after your last injection.

• Always use birth control during sexual activity.
• Do not get your partner pregnant.
• Do not expose your partner to your semen.

Talk with your MITS healthcare provider if you have any questions.

When to call your care team

Watch the insertion sites for 48 hours (2 days) after your infusion. Your infusion sites are where the IV lines went into your body.

Call your care team if you notice any changes in the area, such as:

• Pain or a burning feeling.
• Redness or other skin color changes.
• Swelling.
• Broken skin.
• Blisters or liquid draining.
• Numbness, tingling, or other changes in sensation (feeling).
• Warm or hot skin.

If you have any questions or concerns, please call the Molecular Imaging and Therapy Service.

• Monday through Friday from 9 a.m. to 5 p.m., call 212-639-3146. Ask for the Molecular Imaging and Therapy Service nurse.
• After 5 p.m., during the weekend, and on holidays, call 212-639-2000. Ask for the Molecular Imaging and Therapy Service fellow on call.