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Targeted Therapy with Radium-223 of Bone Metastases

  • Sergio Baldari
  • Alessandro Sindoni
  • Laura Evangelista
  • Emilio Bombardieri
Chapter

Abstract

223Ra is a targeted alpha therapy approved for treatment of metastatic prostate cancer with symptomatic bone metastases and without known visceral metastases. It documented an overall survival benefit, increased time to symptomatic skeletal event, improved quality of life and good safety profile in the pivotal trial ALSYMPCA.

The patient suitable for treatment must present at least two sites of osseous localization at bone scan, with no visceral involvement and lymph nodal disease within 3 cm diameter (short axis).

First data from clinical practice and from expanded access program confirmed safety and efficacy and highlighted that early use is related to completion of six cycles and better clinical outcome.

During treatment, it is important to evaluate pain response, clinical outcome, complete blood count and ALP at each cycle, while PSA must be assessed only every three cycles. Imaging modalities should be repeated at baseline (to select the right patient) and after at least 8 weeks from last administration (to assess the disease response); only in case of clinical suspicion of relapse, the same modalities could be repeated during treatment to exclude a disease progression.

Keywords

Bone metastases Metastatic castration-resistant prostate cancer Radium-223 Follow-up Safety 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sergio Baldari
    • 1
  • Alessandro Sindoni
    • 1
  • Laura Evangelista
    • 2
  • Emilio Bombardieri
    • 3
  1. 1.Department of Biomedical and Dental Sciences, and of Morphological and Functional ImagesUniversity of MessinaMessinaItaly
  2. 2.Veneto Institute of Oncology IOV – IRCCSPaduaItaly
  3. 3.Department of Nuclear MedicineHumanitas Gavazzeni HospitalBergamoItaly

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