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Treatment of skeletal metastases with 223Ra-chloride

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Abstract

Bone metastases cause significant morbidity to patients with prostate cancer, the most commonly diagnosed solid cancer in men. In the last decade, the approach to metastatic castrate-resistant prostate cancer has evolved remarkably, with approval of multiple new medications with survival benefit. We review the radiobiology and phases of development of 223Ra (radium), an α-emitter radiopharmaceutical, and discuss the clinical implications of its use and its future role in the treatment of prostate cancer. A review of the literature was performed through searches of PubMed and Medline databases and related links in these databases, along with recently published abstracts from major medical meetings. 223Ra is an α-emitter, with high affinity to areas of bone metastases. α-Particles have high energy and short range, causing cytotoxicity to targeted cancer cells without affecting surrounding normal tissues. It has been proven to prolong overall survival, delay symptomatic skeletal events, and improve quality of life, while having a minimal toxicity profile. 223Ra is effective and safe in the treatment of bone metastatic castration-resistant prostate cancer. Additional studies are planned to assess the efficacy of 223Ra in combination with other agents known to be active in advanced prostate cancer.

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Conflict of interest

Dr. Oliver Sartor is an investigator and consultant to Bayer. Drs Chalhoub and Chalouhy declare no conflicts of interest.

Human and animal studies

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Section of Hematology/Medical Oncology, Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave., SL-78, New Orleans, LA, 70112, USA

    Elie Chalhoub

  2. Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon

    Carla Chalouhy

  3. Departments of Medicine and Urology, Tulane Cancer Center, Tulane University School of Medicine, New Orleans, LA, USA

    Oliver Sartor

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  1. Elie Chalhoub
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  2. Carla Chalouhy
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  3. Oliver Sartor
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Correspondence to Elie Chalhoub.

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Chalhoub, E., Chalouhy, C. & Sartor, O. Treatment of skeletal metastases with 223Ra-chloride. Clin Transl Imaging 3, 159–165 (2015). https://doi.org/10.1007/s40336-015-0103-5

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