Use of Radium-223 Dichloride in Patients With Osteonecrosis of the Jaw Induced by Zoledronic Acid: Report of 2 Cases

Dionisi, Valeria; Bellarosa, Chiara; Cardano, Raffaele; Rizzini, Elisa Lodi; Ghedini, Pietro; Morganti, Alessio Giuseppe; Fanti, Stefano; Monari, Fabio

doi:10.1016/j.clgc.2019.03.002

Cited by 3 publications

(2 citation statements)

References 27 publications

(35 reference statements)

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“…Automated modules are regularly used to ensure consistency of labeling the radionuclide to the target to produce the radiopharmaceutical. The so-called GMP module is utilized for the pharmaceutical labeling of a limited number of radionuclides for clinical diagnosis and therapy, namely, 18 F, 11 C, 15 O, 13 N, 68 Ga, 99m Tc, 90 Y and 177 Lu [85][86][87][88].…”

Section: Automation Of the Labeling Procedures Towards Gmp Productionmentioning

confidence: 99%

“…Radiometals have been used extensively in clinical diagnostics over the last three decades, particularly, 99m Tc, 67 Ga and 111 In for SPECT and, more recently, 68 Ga, 89 Zr and 64 Cu for PET (Table 1). On the other hand" therapeutic radiometals in clinical use are limited to 177 Lu [8][9][10], 90 Y [11,12], 89 Sr [13,14] and 223 Ra [15,16]. 223 Ra is the only approved radionuclide by health authorities for targeted alpha therapy to extend survival [17].…”

Section: Introductionmentioning

confidence: 99%

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A Step-by-Step Guide for the Novel Radiometal Production for Medical Applications: Case Studies with 68Ga, 44Sc, 177Lu and 161Tb

et al. 2020

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The production of novel radionuclides is the first step towards the development of new effective radiopharmaceuticals, and the quality thereof directly affects the preclinical and clinical phases. In this review, novel radiometal production for medical applications is briefly elucidated. The production status of the imaging nuclide 44Sc and the therapeutic β--emitter nuclide 161Tb are compared to their more established counterparts, 68Ga and 177Lu according to their targetry, irradiation process, radiochemistry, and quality control aspects. The detailed discussion of these significant issues will help towards the future introduction of these promising radionuclides into drug manufacture for clinical application under Good Manufacturing Practice (GMP).

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Section: Automation Of the Labeling Procedures Towards Gmp Productionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Step-by-Step Guide for the Novel Radiometal Production for Medical Applications: Case Studies with 68Ga, 44Sc, 177Lu and 161Tb

et al. 2020

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Radium-223-chloride/zoledronic acid

2019

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Use of Radium223 in metastatic prostate cancer patient in treatment with denosumab: a potential trigger for Osteonecrosis of the jaw? A case report.

Pavese¹,

Rotondaro

2021

Preprint

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Radium-223 dichloride (Ra223) is an alpha-emitting radiopharmaceutical agent approved for the treatment of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases. Denosumab, a human monoclonal antibody targeting the key bone resorption mediator RANKL, has shown to reduce the risk of skeletal-related events in patients with bone metastases from solid tumors. Osteonecrosis of the jaws (ONJ) is an important potential adverse event associated with the use of denosumab or other bone health agents (BHA) like bisphosphonates. In a phase III study conducted to investigate safety and efficacy of Ra223, ONJ was reported in 0.67% of patients treated with Ra223 and in 0.33% of patients who received placebo; however, all patients with ONJ were also exposed to prior or concomitant BHA. Furthermore, denosumab has been associated with prolonged survival in patients treated with Ra223, and a BHA therapy should be considered during Ra223 treatment in order to prevent Ra223 induced bone fractures. Considering that background, we report the case of a 67-year-old man with metastatic CRPC already exposed for almost 4 years to denosumab, who developed ONJ during concomitant Ra223 therapy. Despite contrasting findings in real life experiences, our case suggests to carry out a close monitoring of oral health in patients receiving Ra223 with previous long exposure to denosumab.

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Use of Radium-223 Dichloride in Patients With Osteonecrosis of the Jaw Induced by Zoledronic Acid: Report of 2 Cases

Cited by 3 publications

References 27 publications

A Step-by-Step Guide for the Novel Radiometal Production for Medical Applications: Case Studies with 68Ga, 44Sc, 177Lu and 161Tb

A Step-by-Step Guide for the Novel Radiometal Production for Medical Applications: Case Studies with 68Ga, 44Sc, 177Lu and 161Tb

Radium-223-chloride/zoledronic acid

Use of Radium223 in metastatic prostate cancer patient in treatment with denosumab: a potential trigger for Osteonecrosis of the jaw? A case report.

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