Clinical aspects of mCRPC management in patients treated with radium-223.

Abstract

Bone is the most common site of metastasis in metastatic castration-resistant prostate cancer (mCRPC), which is associated with pain and skeletal events. Radium-223 dichloride (Xofigo) is an alpha-emitting radioactive isotope that can specifically target bone lesions. Herein, we report the results of a retrospective analysis that documents our experience in the use of radium-223. Data from 63 patients (pts) with mCRPC who underwent radium-223 treatment from December 2015 to September 2017 were collected. Radium-223 (55 kBq/kg) was administered every 4 weeks for up to 6 cycles. The primary endpoint was OS. Radium-223 was administered as first line therapy in 11 pts, as second line in 19 pts, as third line in 16 pts and in successive lines in 17 pts; 42 pts out of 63 (67%) completed all six cycles. Within one month after the end of 6 cycles of radium-223, 15 pts out of 42 (35.7%) had achieved PR, 11 pts out of 42 (26.2%) had SD and 14 pts out of 42 (33.3%) had PD. Levels of pain decreased with progressive cycles of radium-223. After a minimum follow-up of 2 months and a maximum of 43 months, median OS was 15 months and median PFS was 8 months. The most frequent radium-223 related toxicity was low grade haematologic toxicity, predominantly G1-G2, that occurred halfway through treatment in about 75% of pts. The favourable results reported herein confirm that radium-223 can be considered well tolerated and effective in mCRPC, and is associated with significant decreases in pain.

• Authors: Elisa Lodi Rizzini, Valeria Dionisi, Pietro Ghedini, Alessio Giuseppe Morganti, Stefano Fanti, Fabio Monari
• Journal: Scientific reports (Sci Rep) Vol. 10 Issue 1 Pg. 6681 (04 21 2020) ISSN: 2045-2322 [Electronic] England
• PMID: 32317750 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hemoglobins
• Radium-223
• Alkaline Phosphatase
• Prostate-Specific Antigen
• Radium

Topics

• Aged
• Alkaline Phosphatase (metabolism)
• Anemia (complications)
• Bone Neoplasms (secondary)
• Cohort Studies
• Hemoglobins (metabolism)
• Humans
• Kaplan-Meier Estimate
• Male
• Pain (etiology)
• Prostate-Specific Antigen (metabolism)
• Prostatic Neoplasms, Castration-Resistant (blood, complications, diagnostic imaging, therapy)
• Radium (therapeutic use)