title: The safety and efficacy of radium-223 dichloride for the treatment of advanced prostate cancer.
abstract: BACKGROUND
  A number of drugs have been shown to extend life expectancy in castration-resistant prostate cancer (CRPC). Skeletal related events (SREs) secondary to bone metastases cause significant morbidity for men with CRPC. The α-emitting radiopharmaceutical radium-223 dichloride has been shown to improve overall survival, time to symptomatic skeletal events (SSEs) and quality of life in CRPC.
  
  
  METHODS
  The development of radium-223 from pre-clinical studies to the evidence of efficacy and safety from a phase 3 trial is discussed as well as its pharmacokinetics and metabolism. The integration of radium-223 into routine care for patients with advanced prostate cancer is included including a comparison with other agents in this setting. Expert commentary: The risk/benefit ratio for radium-223 is very similar to that of other agents used in the CRPC setting and is a treatment option for men unsuitable for cytotoxic chemotherapy because of comorbidities. The ALSYMPCA trial demonstrated an improvement in SSEs with radium-223. This is a clinically relevant end-point as not all radiologically-detected SREs are apparent to patients. The correct sequencing of the life-prolonging treatments available to men with CRPC is subject to debate. Radium-223 therapy should be considered before the development of visceral metastases. Drug-combination studies are underway.
authors: a Departments of Radiotherapy and Urology , The Royal Marsden Hospital , Sutton , UK.|b Department of Radiotherapy & Imaging , The Institute of Cancer Research , Sutton , UK.
authors: James M
authors: JM
authors: Wilson
authors: a Departments of Radiotherapy and Urology , The Royal Marsden Hospital , Sutton , UK.|b Department of Radiotherapy & Imaging , The Institute of Cancer Research , Sutton , UK.
authors: Christopher
authors: C
authors: Parker
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D006801:Humans; D008297:Male; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life; D011868:Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D011883:Radium / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011868:Radioisotopes; C581106:radium Ra 223 dichloride; D011883:Radium
keywords: 223Radium; Castration-resistant prostate cancer; Radium-223 dichloride; bone metastases; symptomatic skeletal events; α-emitter