(223)Ra prolongs overall survival in symptomatic patients affected by multiple bone-metastatic castration-resistant prostatic cancer, without visceral or nodal involvement. However, many questions remain about its mechanisms of action, and its use in clinical practice is still unresolved. First of all, what is the main target of alpha-particle emission, that is, in what way does it influences the tumor microenvironment? When is the best timing in the course of the disease, extending its use to asymptomatic low-volume or even to the micrometastatic phase? What are suitable biomarkers to be employed as prognostic factors and response indicators? Which associations with other drugs and their sequence can offer the best results, and is their effect additive or synergistic? Ultimately, in the current climate of spending review, what is the optimal cost and benefit ratio regarding available treatments? In this review, we tried to answer these questions by analyzing the available scientific literature.
Anticancer research. 2016 Nov [Epub]
Federica Eleonora Buroni, Marco Giovanni Persico, Francesca Pasi, Lorenzo Lodola, Rosanna Nano, Carlo Aprile
Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Radiotherapy Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Lazzaro Spallanzani Department of Biology and Biotecnology, University of Pavia, Pavia, Italy., Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy .