Novel Approaches of Treatment with Radium-223 Targeted Therapy

  • Giovanni Luca Ceresoli
  • Letizia Gianoncelli
  • Maria Bonomi
  • Eleonora Cerchiaro
  • Emilio Bombardieri
Chapter

Abstract

The role of radium-223 (Ra-223) in metastatic castration-resistant prostate cancer (mCRPC) with bone metastases and no visceral disease is well established in clinical practice. Treatment with Ra-223 is well tolerated and significantly improves overall survival and time to first symptomatic skeletal event. Several questions, however, remain open. Patient selection is critical, and treatment assessment is challenging. There is no standard imaging, and PSA has limited usefulness in this setting.

Furthermore, the optimal schedule and dosing of Ra-223 remain to be defined by current trials. Combined treatments with AR-targeting agents such as abiraterone and enzalutamide will probably extend the use of Ra-223 to cases with concomitant bone and visceral disease. Due to ist peculiar mechanism of action and good toxicity profile, Ra-223 is being explored beyond mCRPC in several other neoplasms with predominant bone disease.

Keywords

Radium-223 Prostate cancer Bone metastases Patient selection Combined therapy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Giovanni Luca Ceresoli
    • 1
    • 2
  • Letizia Gianoncelli
    • 1
  • Maria Bonomi
    • 1
  • Eleonora Cerchiaro
    • 1
  • Emilio Bombardieri
    • 3
  1. 1.Department of Medical OncologyCliniche Humanitas GavazzeniBergamoItaly
  2. 2.Thoracic and GU Oncology Unit, Cliniche Humanitas GavazzeniBergamoItaly
  3. 3.Department of Nuclear MedicineCliniche Humanitas GavazzeniBergamoItaly

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