Metabolism and pharmacokinetics of radium-223 in prostate cancer.
BACKGROUND
Prostate cancer metastatic to bone is a cause of significant morbidity and mortality. Bone pain and other skeletal events negatively impact the quality of life in patients who might otherwise be functioning well. As such, there has been intense interest in the development of strategies and pharmaceuticals to address this problem.


METHODS
The authors reviewed the current literature for articles relevant to metastatic prostate cancer, clinical radiopharmaceuticals, castrate-resistant prostate cancer and development of Radium-223 . The authors have referenced primary literature, clinical trials and relevant review articles that summarize the history, development and current utilization of radiopharmaceuticals for management of bone metastases from prostate cancer.


CONCLUSIONS
Radium-223 is the first radiopharmaceutical with an overall survival benefit approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastasis and no known visceral metastatic disease. The additional benefit of clinically significant improved overall survival should lead to exploration of whether this agent can be used earlier in the treatment algorithm or combined with chemotherapy or androgen deprivation therapy. An individualized approach needs to be tailored to each patient based on their overall symptoms, disease burden, hematologic profile and goals of care.
Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, Genitourinary Oncology Service , 1275 York Avenue, New York, NY 10065 , USA +1 646 422 4470 ; slovins@mskcc.org.
Oladapo
O
Yeku
Susan F
SF
Slovin
D000818:Animals; D000970:Antineoplastic Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D006801:Humans; D008297:Male; D057285:Precision Medicine; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy / Q000473:pathology; D011788:Quality of Life; D011868:Radioisotopes / Q000493:pharmacokinetics / Q000627:therapeutic use; D011883:Radium / Q000493:pharmacokinetics* / Q000627:therapeutic use; D015996:Survival Rate
D000970:Antineoplastic Agents; D011868:Radioisotopes; C581106:radium Ra 223 dichloride; D011883:Radium
alpharadin; bone metastases; metastatic castrate-resistant prostate cancer; radionuclide therapy; radium-223