title: Radium-223  for the treatment of prostate cancer.
abstract: BACKGROUND
  Bone metastases cause significant morbidity and mortality in castration-resistant prostate cancer (CRPC). Until recently, treatment options have been limited, but now six drugs are known to extend life expectancy, with docetaxel the current standard first-line cytotoxic therapy. Phase III studies have also shown a survival advantage for sipuleucel-T, cabazitaxel, abiraterone, enzalutamide and radium-223 . Radium-223 is unique among these agents, as the only bone-directed therapy shown to prolong survival in CRPC.
  
  
  METHODS
  This review covers the current standard of care for CRPC and recent drug developments that have demonstrated a survival benefit. It focuses on bone-directed therapies, in particular radium-223, the first-in-class alpha-emitting radionuclide and discusses the pivotal studies to date. A PubMed search using the keywords below was performed.
  
  
  CONCLUSIONS
  Radium-223 is set to become a new standard of care for the treatment of bony metastatic CRPC. It improves both survival and quality of life, delays skeletal events and is well tolerated. Its optimal use in the evolving treatment strategies for men with CRPC and bone metastases is yet to be determined.
authors: Royal Marsden Hospital, Sutton, UK.
authors: Shaista
authors: S
authors: Hafeez
authors: Christopher
authors: C
authors: Parker
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011883:Radium / Q000627:therapeutic use*
chemical_list: D011883:Radium