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radium -223 only FDA approved Targeted Alpha Therapy

  • From the Desk of the Editor

    Welcome to the Center of Excellence on Castration Resistant Prostate Cancer (CRPC) with Bone Metastases. I am Dr. Neal Shore, MD, FACS, CPI, Director of the Carolina Urologic Research Center (CURC), Atlantic Urology Clinics, Myrtle Beach, South Carolina. Founded in 1998, CURC is currently supported by 13 Urologists, 3 Radiation Oncologists, 1 Pathologist, 10 Advanced Practice Providers, and a team of 10 fulltime research and administrative CURC personnel.
    Published June 30, 2017
  • TAT-10: Changes to Alkaline Phosphatase Dynamics and Overall Survival in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223 in an International Early Access Program

    Kanazawa, Japan (UroToday.com) Identifying a reliable marker that is highly correlated with improved overall survival and reduced adverse events for Ra223 treatment would greatly aid the clinical management of metastatic castration-resistant prostate cancer (mCRPC) patients. Bone alkaline phosphate (ALP) is a marker for osteoblasts in bone tissue.
    Published June 21, 2017
  • TAT-10: Development of Effective Chelators for Th227 to be Used in Targeted Thorium Conjugates

    Kanazawa, Japan (UroToday.com) Ra223 represents a breakthrough in alpha therapy after FDA approval in May 2013 of Ra223 – dichloride (XOFIGO) for the treatment of metastatic castration-resistant prostate cancer. As a calcium analog, Ra223 is well-suited for treatment of bone metastases but the absence of efficient chelators limit its use in other types of radiotherapy. The same generators used for Ra223 production can be also be used for highly purified Th-227. This study aims to produce efficient chelators for Th227.
    Published June 21, 2017
  • TAT-10: High-resolution Alpha Camera imaging as a tool for developing Targeted Alpha Therapy

    Kanazawa, Japan (UroToday.com) Alpha particle dose can be highly non-uniform within an organ so microdosimetry with high resolution imaging is required for accurate dosimetry measure. An alpha camera is described to accomplish this.
    Published June 21, 2017
  • TAT-10: Optimization of the patient dosimetry in alphatherapy

    Kanazawa, Japan (UroToday.com) Accurate dosimetry is essential in order to deliver maximum dosage to the tumor site while minimizing the dose to other organs at risk. This study develops tools for measuring the dose from Ra223. The range of alphas is to too short to image directly in humans but the decay of Ra223 also emits gamma rays as the daughter nuclei de-excite to their ground state. These gammas can be detected. SPECT imaging of the gammas was investigated for the first time.
    Published June 21, 2017
  • TAT-10: Radium 223 from Bench to Bedside, and Future Directions for Targeted Alpha Therapy

    Kanazawa, Japan (UroToday.com) Dr. Joe O’Sullivan, a Professor of Radiation Oncology at Queen’s College, briefly reviewed the history of radiation treatment of cancer (and prostate cancer in particular) beginning with Radium treatment only eight years after its discovery by the Curies. A landmark paper on radioactive phosphorous treatment of bone-metastatic prostate cancer was published in the journal Lancet in 1964. More recent internal treatments have concentrated on calcium analogs that are directly absorbed in the bone tumor, starting with Sr98, a beta emitter. Single agent beta emitters showed some (~50 %) palliative response but no benefit for overall survival.
    Published June 21, 2017
  • TAT-10: Radium-223 in Asymptomatic Metastatic Castration Resistance Prostate Cancer Patients Treated in an International Early Access Program (iEAP)

    Kanazawa, Japan (UroToday.com) The purpose of this study was to see if there were significant differences in asymptomatic patients at baseline compared to symptomatic patients for early treatment with Ra223. Asymptomatic was defined as no pain and no opioid use. In other selection criteria, malignant lymphadenopathy > 6cm and visceral disease were excluded.
    Published June 21, 2017
  • TAT-10: Reduction of Radiation Exposure to the Large Intestine During Ra223 Alpha Therapy with Oral Administration of Barium Sulfate

    Kanazawa, Japan (UroToday.com) Ra223 alpha therapy has been shown to be effective in treating bone metastases of metastatic castration-resistant prostate cancer patients. However, some patients have shown gastrointestinal side effects such as nausea and diarrhea. In this mouse study, we investigate whether these side effects may be reduced by oral administration of barium sulfate (BaSO4), a co-precipitating agent of Ra. 
    Published June 21, 2017
  • TAT-10: Session IV: Nanocarriers

    Kanazawa, Japan (UroToday.com) There is a substantial problem with binding the radioisotope to a molecular structure. Isotopes like Ra223 and Ac225 have decay chains that emit a total of four alphas. When the first decay occurs, the recoil of the daughter nucleus is sometimes sufficient to break the molecular bond holding the radioisotope. For the isotopes above, one of the daughter nuclei has a long enough half-life to travel through the body. This is doubly bad since not only is the alpha lost to the tumor site but the free isotope may damage healthy organs, especially the liver and kidneys.
    Published June 21, 2017
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