Radium-223 in the treatment of bone metastases in patients with castration-resistant prostate cancer. Review and procedure

Orcajo-Rincón, J.; Caresia-Aróztegui, A.P.; Cózar-Santiago, M. del Puig; García-Garzón, J.R.; Arcocha-Torres, M. de; Delgado-Bolton, Roberto; García-Velloso, María José; Álvarez-Ruiz, Sara; García-Vicente, Ana María

doi:10.1016/j.remnie.2018.03.001

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…1 Metastatic growth in distant organs, especially bone (the most common metastatic site) 2,3 is the major cause of the high mortality rate. Although there have several strategies (including surgery, radiotherapy, chemotherapy, androgen deprivation therapy, radionuclide, diphosphate, zoledronic acid, et al) recommended for the treatment of PCa bone metastasis, 4,5 most of them are palliative, not curative. Therefore, it is urgent to explore new therapeutic approaches for this disease.…”

Section: Introductionmentioning

confidence: 99%

Identification of HCG18 and MCM3AP-AS1 That Associate With Bone Metastasis, Poor Prognosis and Increased Abundance of M2 Macrophage Infiltration in Prostate Cancer

Chen

et al. 2021

Technol Cancer Res Treat

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Background: Bone metastasis is a leading cause of the high mortality rate of prostate cancer (PCa), but curative strategies remain lacking. Recent studies suggest long non-coding RNAs (lncRNAs) may be potential targets to develop drugs. However, PCa bone metastasis-specifically-related lncRNAs were rarely reported. This study aimed to identify crucial lncRNAs and reveal their function mechanisms. Methods: GSE32269 and GSE26964 microarray datasets, downloaded from the Gene Expression Omnibus database, were used to analyze differentially expressed genes (DEGs)/lncRNAs (DELs) and miRNAs (DEMs), respectively. Weighted gene co-expression network analysis was performed to screen PCa bone metastasis-associated modules. The co-expression and competing endogenous RNAs (ceRNAs) networks were constructed to identify hub lncRNAs. Univariate Cox regression analysis was conducted to determine their prognostic values. The correlation of lncRNAs with immune infiltrating cells was analyzed by using Tumor IMmune Estimation Resource. Therapeutic drugs were predicted by querying the Connectivity Map (CMap) and the Comparative Toxicogenomics Database (CTD). Results: A total of 18 DELs, 2,614 DEGs and 86 DEMs were screened between bone metastatic and primary PCa samples. Four modules enriched by DEGs were shown to be bone metastasis-associated. LncRNA HCG18 and MCM3AP-AS1 were identified to be important because they existed in both of the co-expression and ceRNA networks (forming the relationship pairs: HCG18/MCM3AP-AS1-KNTC1, MCM3AP-AS1-hsa-miR-508-3p-DTL and HCG18/MCM3AP-AS1-hsa-miR-127-3p-CDKN3). All the genes in these interaction pairs were significantly associated with overall survival of PCa patients. Also, HCG18, MCM3AP-AS1 and their target mRNAs were positively correlated with various tumor-infiltrated immune cells, especially increased M2 macrophages. Valproic acid and trichostatin A may be effective to treat PCa bone metastasis by targeting HCG18 and MCM3AP-AS1. Conclusion: HCG18 and MCM3AP-AS1 that regulate M2 macrophage infiltration may be important targets to treat PCa bone metastasis and improve prognosis.

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Section: Introductionmentioning

confidence: 99%

Identification of HCG18 and MCM3AP-AS1 That Associate With Bone Metastasis, Poor Prognosis and Increased Abundance of M2 Macrophage Infiltration in Prostate Cancer

Chen

et al. 2021

Technol Cancer Res Treat

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“…25 Moreover, considering the potential bone marrow suppression, 223 Ra therapy should be implemented in patients who have not received chemotherapy or who have discontinued it since safety data on combination therapy are lacking. 26 The same is recommended in case of second-line ADT (abiraterone and enzalutamide), as recently confirmed. 27 Conversely, in absence of pathologic fracture of the jaw, zoledronic acid can be continued with safety, as well as ADT and denosumab.…”

Section: Ra-223 For the Treatment Of Metastatic Crpcmentioning

confidence: 87%

Radium-223 for the treatment of bone metastases in castration-resistant prostate cancer: when and why

et al. 2019

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Radium-223 dichloride (223Ra) is the first, recently approved, α-particle-emitting radiopharmaceutical for the treatment of patients with bone metastases in castration-resistant prostate cancer (CRPC) and no evidence of visceral metastases. We explored MEDLINE, relevant congresses, and websites for data on 223Ra and prostate cancer therapies, focusing on therapeutic strategies and timing, bone metastases, and diagnostic assessment. 223Ra represents the only bone-targeting agent that has significantly extended patients’ overall survival while reducing pain and symptomatic skeletal events. Unlike other radiopharmaceuticals, such as strontium-89 and samarium-153 EDTMP, 223Ra (11.4-days half-life) has shown a high biological efficiency mainly due to its short penetration range. These features potentially allow reduced bone marrow toxicity and limit undue exposure. 223Ra has been validated under the product name Xofigo® by the US Food and Drug Administration and the European Medicines Agency. Patient selection, management, and treatment sequencing is recommended to be discussed in the context of a multidisciplinary environment, including oncology, urology, nuclear medicine, and radiation therapy physicians. No consensus has been achieved regarding the optimal timing and its administration as single agent or in combination with zoledronic acid or chemotherapy, so far. This review aims to provide a rationale for the use of 223Ra in treating metastases from CRPC, highlighting the crucial role of a multidisciplinary approach, the disputed inclusion and exclusion criteria on the basis of agencies regulations, and the value of diagnostics for therapy assessment.

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“…While skeletal related events of asymptomatic spinal metastases may be reduced by bone modifying agents [e.g., bisphosphonate or denosumab (63) or radio-nucleotide treatment (64), symptomatic spinal metastases should be assessed by radiation oncologists for consideration of radiation therapy].…”

Section: Spinal Metastasesmentioning

confidence: 99%

Defining the radiation oncologist’s role in palliative care and radiotherapy

Lam¹,

Tseng²

2019

Ann. Palliat. Med.

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Radiation oncologists play an important role in the palliative care of advanced cancer patients.The article discusses the various clinical indications of palliative radiation therapy, which include the control of bone pain, acute treatment of cord compression, the control of thoracic and gastrointestinal symptoms.The importance of survival estimates for individualization of radiation therapy regime is elaborated. Besides prescription of radiation treatment, radiation oncologists should also function as primary palliative care providers by assessing and initial management of symptoms and other sources of distress, making prompt referrals to specialists for complex symptom management and contributing to the multidisciplinary palliative care team. Additionally, communication skills, including prognostic disclosure and goals of care discussions, should also be a core competency of radiation oncologists.

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Radium-223 in the treatment of bone metastases in patients with castration-resistant prostate cancer. Review and procedure

Cited by 5 publications

References 34 publications

Identification of HCG18 and MCM3AP-AS1 That Associate With Bone Metastasis, Poor Prognosis and Increased Abundance of M2 Macrophage Infiltration in Prostate Cancer

Identification of HCG18 and MCM3AP-AS1 That Associate With Bone Metastasis, Poor Prognosis and Increased Abundance of M2 Macrophage Infiltration in Prostate Cancer

Radium-223 for the treatment of bone metastases in castration-resistant prostate cancer: when and why

Defining the radiation oncologist’s role in palliative care and radiotherapy

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