Ra-223 Treatment for Bone Metastases in Castrate-Resistant Prostate Cancer

[pjoshea13]

New paper below.

The sub-title is "Practical Management Issues for Patient Selection", so I figured that potential patients might be interested.

The full text is available. For those contemplating Ra-223, use the following link & click on "Article as PDF":

journals.lww.com/amjclinica...

-Patrick

ncbi.nlm.nih.gov/pubmed/308...

Am J Clin Oncol. 2019 Mar 4. doi: 10.1097/COC.0000000000000528. [Epub ahead of print]

Ra-223 Treatment for Bone Metastases in Castrate-Resistant Prostate Cancer: Practical Management Issues for Patient Selection.

Den RB1, George D2, Pieczonka C3, McNamara M2.

Author information

Abstract

Bone metastases are common in men with metastatic castrate-resistant prostate cancer (mCRPC), occurring in 30% of patients within 2 years of castrate resistance and in >90% of patients over the disease course. There are 6 US Food and Drug Administration-approved therapies for mCRPC with demonstrated survival benefit. Of these, only radium-223 (Ra-223) specifically targets bone metastases, delays development of skeletal-related events, and improves survival. This review discusses key data from the ALSYMPCA trial, which contributed to the approval of Ra-223. Data from other trials are highlighted to provide further insight into which patients might benefit from Ra-223. Special patient populations are described, as well as other considerations for the administration of Ra-223. Finally, ongoing trials of Ra-223 combined with other therapies for mCRPC are discussed. These include combining Ra-223 with sipuleucel-T or immunooncology agents, to enhance immune responses, and trials in mildly symptomatic or asymptomatic patients. To date, the optimal timing, sequence, and combinations of Ra-223 with other agents are yet to be determined. The goals of this review are to provide insight into practical aspects of patient selection for Ra-223 treatment and to discuss key therapeutic strategies using the 6 approved mCRPC agents in patients with bone metastases. Results from ongoing trials should help guide the practitioner in using Ra-223 in patients with mCRPC.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. creativecommons.org/license....

PMID: 30844849 DOI: 10.1097/COC.0000000000000528

[monte1111]

Good article. Seems to say that combining Ra-223 with Provenge may be a good idea.