Radium-223 for the Treatment of Painful Bone Metastates in Castration-resistant Prostate Cancer

Abstract

Radium-223 dichloride is an alpha radionuclide therapy and approved for the treatment of castration-resistant prostate cancer with symptomatic bone metastases and no known visceral metastatic disease. In the phase 3 ALSYMPCA trial, patients with metastatic castration-resistant prostate cancer with symptomatic bone metastases and no known visceral metastases were randomly assigned to receive Radium-223 or placebo. Radium-223 Dichloride significantly improved overall survival compared with placebo (median overall survival 14.9 vs. 11.3 months). Radium-223 significantly prolonged the time to the first SRE compared with placebo (median 15.6 vs. 9.8 months). This review aims to evaluate the position of Radium-223 treatment in current guidelines, to discuss the results of key studies and review ongoing studies.