title: Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer.
abstract: 223Ra prolongs overall survival in symptomatic patients affected by multiple bone-metastatic castration-resistant prostatic cancer, without visceral or nodal involvement. However, many questions remain about its mechanisms of action, and its use in clinical practice is still unresolved. First of all, what is the main target of alpha-particle emission, that is, in what way does it influences the tumor microenvironment? When is the best timing in the course of the disease, extending its use to asymptomatic low-volume or even to the micrometastatic phase? What are suitable biomarkers to be employed as prognostic factors and response indicators? Which associations with other drugs and their sequence can offer the best results, and is their effect additive or synergistic? Ultimately, in the current climate of spending review, what is the optimal cost and benefit ratio regarding available treatments? In this review, we tried to answer these questions by analyzing the available scientific literature.
authors: Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Federica Eleonora
authors: FE
authors: Buroni
authors: Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Marco Giovanni
authors: MG
authors: Persico
authors: Radiotherapy Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Francesca
authors: F
authors: Pasi
authors: Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Lorenzo
authors: L
authors: Lodola
authors: Lazzaro Spallanzani Department of Biology and Biotecnology, University of Pavia, Pavia, Italy.
authors: Rosanna
authors: R
authors: Nano
authors: Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy c.aprile@smatteo.pv.it.|Fondazione CNAO, National Centre of Oncological Hadrontherapy, Pavia, Italy.
authors: Carlo
authors: C
authors: Aprile
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D017850:Economics, Pharmaceutical; D006801:Humans; D008297:Male; D011379:Prognosis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000473:pathology / Q000532:radiotherapy*; D011883:Radium / Q000627:therapeutic use*
chemical_list: D011883:Radium
keywords: Radium-223; bone metastases; castration-resistant prostatic cancer; palliation of pain; pharmacoeconomics; radiometabolic therapy; review