Radium-223 for the treatment of bone metastases in castration-resistant prostate cancer: when and why(18 visite) Gallicchio R, Mastrangelo PA, Nardelli A, Mainenti PP, Colasurdo AP, Landriscina M, Guglielmi G, Storto G
Tumori (ISSN: 0300-8916linking), 2019 May 16; N/D: 300891619851376-300891619851376.
Tipo di articolo: Journal Article
Impact factor: 1.304, Impact factor a 5 anni: 1.069
Url: Non disponibile.
Parole chiave: Radium-223, Bone Metastases, Castration-Resistant Prostate Cancer, Multidisciplinary Approach, Rules
*** IBB - CNR *** 1 Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico della Basilicata (CROB), Rionero in Vulture, Italy. 2 Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy. 3 Dipartimento di Medicina Clinica e Sperimentale, Universita degli Studi di Foggia, Italy. 4 IRCCS "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy.
Radium-223 dichloride ((223)Ra) is the first, recently approved, alpha-particle-emitting radiopharmaceutical for the treatment of patients with bone metastases in castration-resistant prostate cancer (CRPC) and no evidence of visceral metastases. We explored MEDLINE, relevant congresses, and websites for data on (223)Ra and prostate cancer therapies, focusing on therapeutic strategies and timing, bone metastases, and diagnostic assessment. (223)Ra represents the only bone-targeting agent that has significantly extended patients' overall survival while reducing pain and symptomatic skeletal events. Unlike other radiopharmaceuticals, such as strontium-89 and samarium-153 EDTMP, (223)Ra (11.4-days half-life) has shown a high biological efficiency mainly due to its short penetration range. These features potentially allow reduced bone marrow toxicity and limit undue exposure. (223)Ra has been validated under the product name Xofigo((R)) by the US Food and Drug Administration and the European Medicines Agency. Patient selection, management, and treatment sequencing is recommended to be discussed in the context of a multidisciplinary environment, including oncology, urology, nuclear medicine, and radiation therapy physicians. No consensus has been achieved regarding the optimal timing and its administration as single agent or in combination with zoledronic acid or chemotherapy, so far. This review aims to provide a rationale for the use of (223)Ra in treating metastases from CRPC, highlighting the crucial role of a multidisciplinary approach, the disputed inclusion and exclusion criteria on the basis of agencies regulations, and the value of diagnostics for therapy assessment.<br>