Evaluating the effectiveness and safety of radium-223 dichloride treatment in real-world patients with metastatic castration-resistant prostate cancer.

The study evaluated the effectiveness and safety of radium-223 dichloride (Xofigo) treatment in real-world patients with metastatic castration-resistant prostate cancer (mCRPC). The data showed that radium-223 dichloride treatment was well tolerated and reduced pain in real-world patients with mCRPC spread to the bone.

Metastatic CRPC is an aggressive form of prostate cancer that has spread beyond the prostate gland and is no longer responsive to hormonal therapy such as androgen deprivation therapy (ADT). ADT reduces the production of androgens (male sex hormones such as testosterone). Reducing these androgens prevents cancer cell growth. The bones are a common site for PC metastasis (spread).

Radium-223 dichloride is approved for the treatment of patients with mCRPC that has spread to the bones. Radium-223 is a drug that contains a radioactive substance that targets cancer in the bone. It then releases radiation directly to the cancer in the bone, without damaging healthy surrounding tissue. Early studies have demonstrated a survival advantage and reduced cancer pain with radium-223. However, in clinical trials, patients are carefully selected to be fit and without additional medical conditions. Therefore, the effectiveness and safety of radium-223 dichloride treatment in real-world patients with mCRPC are still unknown.

This study included 160 patients from Finland with mCRPC spread to the bone. Patients received radium-223 dichloride treatment.

The average overall survival was 13.8 months. The average survival without cancer worsening was 4.9 months.

Normal alkaline phosphatase levels (ALP; enzyme in the blood indicating bone tumor growth) before the start of treatment or lower ALP levels during radium-223 treatment showed a significant benefit in overall survival.

High prostate-specific antigen (PSA; protein made by cells of the prostate gland) level (≥100 μg/L) before radium-223 treatment was associated with significantly poor overall survival compared to low PSA level (<20 μg/L).

57% of the patients experienced pain relief. Pain relief was associated with significantly better overall survival. 12.5% of the patients experienced serious side effects. The most common side effects were low red blood cell counts, low white blood cell counts, and low platelet counts.

This study concluded that radium-223 dichloride treatment was well tolerated and reduced pain in real-world patients with mCRPC spread to the bone.

The sample size was very small. This study looked back in time at medical records. The study only included patients from Finland.