Radium-223 dichloride for the treatment of castration-resistant prostate cancer with symptomatic bone metastases

ABSTRACT

Introduction: Castration-resistant prostate cancer (CRPC) is associated with the development of bone metastases, increased mortality, and a reduction in the patient’s quality of life (QOL). The management of metastatic CRPC (mCRPC) has rapidly evolved over the past decade, with a number of available therapeutic agents improving overall survival. Radium-223 dichloride (radium-223), the first targeted alpha therapy, improves survival accompanied by QOL benefits with a favorable safety profile. It is approved in over 40 countries for the treatment of patients with CRPC with symptomatic bone metastases and no known visceral metastatic disease.

Areas covered: The current management of CRPC in men with bone metastases, and in particular the role of radium-223 in this setting, is reviewed and discussed. A search of bibliographic databases for peer-reviewed literature and major meetings was conducted.

Expert commentary: In treating patients with mCRPC, the best sequencing and/or combination of radium-223 with other agents has yet to be fully elucidated. The role of radium-223 in treating patients with hormone-sensitive metastatic prostate cancer who are candidates for chemotherapy should also be investigated in well-designed trials. The ability to tailor radium-223 therapy to both the clinical and genetic profiles of CRPC patients would be a promising development.

KEYWORDS:

• Radium-223
• bone metastases
• castration-resistant prostate cancer
• targeted alpha therapy
• sequencing
• combination

Declaration of interest

NJ Vogelzang has received grants from and is on the speakers bureau for Bayer. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Medical writing support was provided by Joanna K. Sandilos Rega, PhD, and Heather L. Nyce, PhD, CMPP, of SciStrategy Communications, funded by Bayer HealthCare Pharmaceuticals.

Additional information

Funding

This manuscript was funded by Bayer HealthCare Pharmaceuticals.