title: Radium-223 dichloride therapy in breast cancer with osseous metastases.
abstract: Osseous metastases occur frequently in patients with breast cancer. Few options exist for bone targeted therapy for hormone refractory patients with breast cancer with progressive bone metastases. We present a case of breast cancer with osseous metastases but no visceral metastases. The patient had been treated with surgery, chemotherapy, radiation and hormonal therapy, but still had extensive symptomatic osseous metastases. She received radium-223 dichloride, a therapeutic radiopharmaceutical Food and Drug Administration (FDA) approved for castration resistant prostate cancer with bone metastases. She tolerated the therapy well with no significant adverse effects. She had an excellent response with significant pain relief obviating need for regular analgaesics. Her tumour markers also dropped significantly. Osseous metastases assessed with F-18 fluorodeoxy glucose (FDG) positron emission tomography/CT (PET/CT) and F-18 sodium fluoride (NaF) bone PET/CT) scans at baseline, after two and six cycles, also showed interval improvement in the lesions. Radium-223 dichloride could potentially be a safe and useful therapeutic option in this setting.
authors.affiliation: Center for Molecular Imaging & Therapy, Biomedical Research Foundation of Northwest Louisiana, Shreveport, Louisiana, USA Department of Radiology, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA.
authors.forename: Amol
authors.initials: A
authors.lastname: Takalkar
authors.affiliation: Center for Molecular Imaging & Therapy, Biomedical Research Foundation of Northwest Louisiana, Shreveport, Louisiana, USA.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Paryani
authors.affiliation: Department of Radiology, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Adams
authors.affiliation: Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Subbiah
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D056687:Off-Label Use; D049268:Positron-Emission Tomography; D011868:Radioisotopes / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011883:Radium / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; C090797:CA 27-29 antigen; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000469:Alkaline Phosphatase; C581106:radium Ra 223 dichloride; D011883:Radium