Radium-223 Within the Evolving Treatment Options for Metastatic Castration-resistant Prostate Cancer: Recommendations from a European Expert Working Group

Joe M. O'Sullivan, Joan Carles, Richard Cathomas, Alfonso Gomez-Iturriaga, Daniel Heinrich, Gero Kramer, Piet Ost, Inge van Oort, Bertrand Tombal

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Several ongoing clinical trials are investigating novel therapies and combinations of existing therapies for the treatment of patients with metastatic castration-resistant prostate cancer. One such trial, ERA 223, has shown that the combination of abiraterone plus radium-223 did not improve symptomatic skeletal event-free survival compared with abiraterone plus placebo. Furthermore, an increase in bone fractures was observed with the combination of abiraterone and radium-223 in the study, particularly in patients not receiving bone health agents (denosumab or zoledronic acid). The results led to a change in the indication of radium-223 in Europe and also highlighted a need for greater awareness of bone health in patients with prostate cancer. Following a meeting to discuss these issues, we report in this article our views on the role of radium-223 within the emerging treatment options for patients with metastatic castration-resistant prostate cancer. We discuss best practices, and provide expert recommendations for preserving bone health and sequencing of life-prolonging therapies in patients with prostate cancer in order to achieve optimal outcomes. PATIENT SUMMARY: We provide recommendations on maintaining bone health, sequencing of treatments, and the role of radium-223 therapy in prostate cancer. Radium-223 is a valuable treatment option for patients with castration-resistant prostate cancer and bone metastases. Monitoring and maintaining bone health are essential for patients with prostate cancer, and should be considered at the initiation of androgen deprivation therapy.

Original languageEnglish
Pages (from-to)455-463
Number of pages9
JournalEuropean urology oncology
Volume3
Issue number4
Early online date26 Mar 2019
DOIs
Publication statusPublished - 01 Aug 2020

Bibliographical note

Publisher Copyright:
Copyright © 2019. Published by Elsevier B.V.

Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine

Keywords

  • Bone health
  • Prostate cancer
  • Radium-223
  • Treatment sequence

ASJC Scopus subject areas

  • Medicine(all)

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