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.
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 2017 Nov 02 [Epub ahead of print]
A Rodriguez-Vida, M D Torregrosa, Á Pinto, M Á Climent, D Olmos, J Carles
Medical Oncology Department, Hospital del Mar, Barcelona, Spain., Medical Oncology Department, Doctor Peset University Hospital, Valencia, Spain., Medical Oncology Department, La Paz University Hospital, Madrid, Spain., Medical Oncology Department, Valencia Institute of Oncology, Valencia, Spain., Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain., 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. .