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Selection and monitoring of patients with metastatic castration-resistant prostate cancer for treatment with radium-223

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Abstract

Despite the improvement provided by androgenic suppression in the treatment of prostate cancer, most of tumors develop resistance to castration. However, new therapies have demonstrated an increase in patient survival such as radium-223 (Ra-223), an alpha emitter and calcium mimetic with the capability of targeting osteoblastic metastatic lesions. According to results of the ALSYMPCA phase III trial, Ra-223 has demonstrated its activity by improving symptoms and survival of patients with metastatic castration-resistant prostate cancer (mCRPC), symptomatic bone metastases, and no known visceral metastatic disease, without interfering with subsequent treatments. This review examines the key evidence to establish the best patient selection criteria to use Ra-223, how to assess the response to treatment, treatment-related toxicity, and follow-up, but also current research regarding imaging techniques and biomarkers to assess the efficacy of Ra-223. Finally, we briefly describe the clinical trials that are currently ongoing with Ra-223.

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Acknowledgements

The authors wish to thank Dr. Fernando Sánchez-Barbero from HealthCo S.L. (Madrid, Spain) for his help in the preparation of the manuscript. Bayer Spain provided comment on the first draft of this manuscript, but thereafter, the authors made all the decisions about its contents.

Author information

Authors and Affiliations

  1. Medical Oncology Department, Hospital del Mar, Barcelona, Spain

    A. Rodriguez-Vida

  2. Medical Oncology Department, Doctor Peset University Hospital, Valencia, Spain

    M. D. Torregrosa

  3. Medical Oncology Department, La Paz University Hospital, Madrid, Spain

    Á. Pinto

  4. Medical Oncology Department, Valencia Institute of Oncology, Valencia, Spain

    M. Á. Climent

  5. Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain

    D. Olmos

  6. Medical Oncology Department, CNIO-IBIMA Genito-Urinary Cancer Unit, Virgen de la Victoria and Regional of Malaga University Hospital, Málaga, Spain

    D. Olmos

  7. Medical Oncology Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Passeig de la Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    J. Carles

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  1. A. Rodriguez-Vida
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  2. M. D. Torregrosa
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  3. Á. Pinto
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  4. M. Á. Climent
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  5. D. Olmos
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Corresponding author

Correspondence to J. Carles.

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Conflict of interest

A Pinto declared that he has received speaker’s fees from Bayer Spain and he has also been advisor for Bayer Spain. A Rodriguez-Vida declared that he has received speaker’s fees from Bayer Spain and he has also been advisor for Bayer Spain. D Olmos declared that he has received research funding and speaker’s fees from Bayer Spain and he has also been advisor for Bayer Spain. D Torregrosa declared she has received speaker’s fees from Bayer Spain. J Carles declared that he has received speaker’s fees from Bayer Spain and he has also been advisor for Bayer Spain. MA Climent declared that he has received speaker’s fees from Bayer Spain.

Ethical statement

The study has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments. This article does not contain any studies with human participants or animals performed by any of the authors.

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Rodriguez-Vida, A., Torregrosa, M.D., Pinto, Á. et al. Selection and monitoring of patients with metastatic castration-resistant prostate cancer for treatment with radium-223. Clin Transl Oncol 20, 679–686 (2018). https://doi.org/10.1007/s12094-017-1785-0

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  • DOI: https://doi.org/10.1007/s12094-017-1785-0

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