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Radium-223 dichloride in castration-resistant prostate cancer with symptomatic bone metastases: a guide to its use

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Abstract

Radium-223 dichloride (Xofigo®) is a first-in-class alpha particle-emitting radiopharmaceutical approved for the treatment of patients with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastatic disease. As a calcium mimetic, radium-223 dichloride targets areas of high bone turnover, delivering cytotoxic radiation to the sites of bone metastases. In the phase 3 ALSYMPCA trial, radium-223 dichloride (administered as six 4-weekly intravenous injections) significantly improved overall survival relative to placebo. The survival benefit was observed irrespective of previous docetaxel use. Radium-223 dichloride also significantly delayed the occurrence of symptomatic skeletal events and had beneficial effects on pain and health-related quality of life. The drug was well tolerated, being associated with low rates of myelosuppression and generally mild gastrointestinal adverse events.

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Acknowledgments

The review was updated from Drugs 2014;74(5):579–86 [12], and was reviewed by: Y. A. Alomi, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia; L. Costa, Hospital de Santa Maria and Instituto de Medicina Molecular, Lisbon, Portugal; S. Saluja, Saran Ashram Hospital, Dayalbagh, Agra, India; R. B. Shah, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India. During the peer review process, the manufacturer of radium-223 dichloride was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Matt Shirley & Paul L. McCormack

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  1. Matt Shirley
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  2. Paul L. McCormack
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Correspondence to Matt Shirley.

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The preparation of this review was not supported by any external funding.

Conflicts of interest

M. Shirley and P. L. McCormack are salaried employees of Adis/Springer, are responsible for the article content and declare no conflicts of interest.

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Shirley, M., McCormack, P.L. Radium-223 dichloride in castration-resistant prostate cancer with symptomatic bone metastases: a guide to its use. Drugs Ther Perspect 32, 98–103 (2016). https://doi.org/10.1007/s40267-016-0283-8

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