Radium-223 as an Additional Therapeutic Strategy in Highly Selected Patients With Metastatic Breast Cancer: A Case Report

Abstract

Radium-223 is commonly used in metastatic prostate cancer, targeting specifically bone metastases. The use of radium-223 remains, however, poorly evaluated in metastatic breast cancer. We report a case of radium-223 treatment in a 59-year-old patient with bone-only metastatic disease that progressed on multiple lines of systemic treatments. Radium-223 was very well tolerated and resulted in a regression of activity of bone metastases and in a 6-month progression-free survival. However, progression occurred in the liver, reflecting the fact that radium-223 should be combined with other systemic agents. This suggests that this therapeutic option is feasible and could be proposed in highly selected patients with bone metastatic disease outside of the prostate cancer field. Positron Emission Tomography appears also as a valuable tool for the evaluation of radium-223 efficacy.

Radium-223 in women with hormone receptor-positive bone-metastatic breast cancer receiving endocrine therapy: pooled analysis of two international, phase 2, randomized, double-blind, placebo-controlled trials

“…In the CARBON study of radium-223 in combination with capecitabine, similar results were reported, with no substantial benefit from the combination over capecitabine alone observed [ 17 ]. However, case reports indicate that radium-223 may have efficacy in patients with bone-only metastases [ 18 ], and most patients with prostate cancer have bone-only or bone-dominant metastases. Overall outcome in most solid tumors other than prostate cancer is usually driven by visceral disease, not by bone disease.…”