Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial

Hoskin, Peter; Sartor, Oliver; O’Sullivan, Joe M.; Johannessen, Dag Clement; Helle, Svein Inge; Logue, John P; Bottomley, David; Nilsson, Sten; Vogelzang, Nicholas J.; Fang, Fang; Wahba, Mona; Aksnes, Anne-Kirsti; Parker, Christopher

doi:10.1016/s1470-2045(14)70474-7

Cited by 363 publications

(310 citation statements)

References 14 publications

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“…ALSYMPCA trial showed that Ra-223 produced a survival bene it in both chemo-naïve patients and in the docetaxel pre-treated subgroup. These indings were further validated in a prespeci ied subgroup analysis of ALSYMPCA patients that con irmed the highly favorable safety pro ile of Ra-223 verifying the low incidence of myelosuppression, irrespective of previous docetaxel use [24]. In our clinical experience, there is a quite balanced proportion between chemo-naïve population and patients pre-treated with docetaxel.…”

Section: Patient Referral and Managementmentioning

confidence: 58%

Ra-223 dichloride management in a Nuclear Medicine Unit: experience of a referral institution

Follacchio¹,

Frantellizzi²,

Monteleone³

et al. 2017

J Radiol Oncol

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Section: Patient Referral and Managementmentioning

confidence: 58%

Ra-223 dichloride management in a Nuclear Medicine Unit: experience of a referral institution

Follacchio¹,

Frantellizzi²,

Monteleone³

et al. 2017

J Radiol Oncol

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“…Previous experiences with bone seeking beta-particle emitters are conflicting. Association of 153 Sm-EDTMP with chemotherapy, EBRT and bisphosphonates gave advantages in terms of pain relief (21,40,90).…”

Section: Association Sequence and Interactionsmentioning

confidence: 99%

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

Buroni

Persico

Pasi

et al. 2016

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Abstract. 223 Prostate cancer (PCa) is the most common malignancy in men (1). In patients affected by advanced PCa, defined as hormonesensitive disease since the tumor still requires androgen for growth, androgen deprivation therapy (ADT), including luteinizing hormone-releasing hormone (LHRH) agonists, antagonists and anti-androgens, represents the first-line treatment. Unfortunately some cancer cells develop resistance to ADT, indicating the progression of the disease to metastatic castration-resistant prostate cancer (mCRPCa). Such resistance to castration occurs in most patients (2) and, despite the approval of new therapeutic agents, mCRPCa remains a lethal disease (3). Nowadays the new therapeutic landscape for patients affected by mCRPCa aims to extend overall survival (OS) and includes cytotoxic, new-generation anti-androgens, immunotherapeutics and radiopharmaceuticals (4, 5).Bones are the preferred site of metastasis. Almost 90% of men who die from PCa have bone-metastatic disease (6), with a 5-year OS rate of 20%. Due to the fragility of bone with metastases, with the related risk of pain, fractures, spinal cord compression and hematological consequences, several drugs have been developed to treat the osseous involvement of this disease. In previous years, the optimal treatment aimed to relieve pain and reduce skeletal morbidity.Besides systemic therapies, bone-targeted agents that focus their activity on bone, such as bisphosphonates, monoclonal antibody and radiopharmaceuticals, have become available. The bisphosphonate zoledronic acid, the antibody to receptor activator of nuclear factor kappa-B ligand (RANKL) denosumab and radiopharmaceuticals [such as 89 Sr and 153 Sm-ethylene diamine tetramethylene phosphonate ( 153 Sm-EDTMP)], were approved for delaying skeletal-related events (SREs) and for the palliation of bone pain from mCRPCa. Radionuclide TherapyRadionuclide therapy is known to deliver ionizing radiation to tumor sites, thereby killing cancer cells (7). Bone-targeted radiopharmaceuticals localize their radiation to sites of high bone remodeling. 5719

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“…The increasing importance of PROMs as a clinical endpoint is now widely recognised, with several recent trials evaluating the effectiveness of drugs in CRPC collecting QOL measures as secondary endpoints. 2,3,18 An example of the incorporation of PROMs in a clinical trial is the COU 302 study, where 1088 asymptomatic or mildly symptomatic men with progressive CRPC without prior chemotherapy were randomised to receive the novel hormonal agent abiraterone (Zytiga) 1000mg/day plus low-dose prednisolone (10mg daily) or placebo plus prednisolone. The final analysis of this trial, after a median follow-up of 49.2 months, showed a significant improvement in median OS in favour of abiraterone and prednisolone compared to prednisolone alone (34.7 months versus 30.3 months; HR 0.81,…”

Section: Proms In Recent Trials In Crpcmentioning

confidence: 99%

Patient‐reported outcome measures in metastatic prostate cancer

Sellers

Savas

Davda

et al. 2016

Trends Urol & Men's Health

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Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial

Cited by 363 publications

References 14 publications

Ra-223 dichloride management in a Nuclear Medicine Unit: experience of a referral institution

Ra-223 dichloride management in a Nuclear Medicine Unit: experience of a referral institution

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

Patient‐reported outcome measures in metastatic prostate cancer

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