Skip to main content

Radiopharmaceutical Therapy in Metastatic CRPC

  • Chapter
  • First Online:
  • 789 Accesses

Abstract

Radiopharmaceuticals are used in the treatment of metastatic castration-resistant prostate cancer. In the United States, four bone-seeking radiopharmaceuticals have been approved. Three of these are β-emitters approved for palliative purposes (phosphorus-32, strontium-89, samarium-153-ethylenediamine tetramethylene phosphonic acid). One α-emitter (radium-223) has been approved for prolonged survival in patients with metastatic prostate cancer. Radiopharmaceuticals for bones have been used for decades in combination with chemotherapy, hormones, and bisphosphonates. Current combinations and clinical trials focus primarily on radium-223, assuming that overall survival benefit is related to this radionuclide. In this chapter, the radiopharmaceutical treatment methods will be elaborated.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004;351(15):1502–12.

    Article  CAS  PubMed  Google Scholar 

  2. de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376(9747):1147–54.

    Article  CAS  PubMed  Google Scholar 

  3. Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(5):424–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011;364(21):1995–2005.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ryan CJ, Smith MR, de Bono JS, Molina A, Logothetis CJ, de Souza P, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013;368(2):138–48.

    Article  CAS  PubMed  Google Scholar 

  6. Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97.

    Article  CAS  PubMed  Google Scholar 

  7. Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, Fossa SD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369(3):213–23.

    Article  CAS  PubMed  Google Scholar 

  8. Baldari S, Boni G, Bortolus R, Caffo O, Conti G, De Vincentis G, et al. Management of metastatic castration-resistant prostate cancer: a focus on radium-223: opinions and suggestions from an expert multidisciplinary panel. Crit Rev Oncol Hematol. 2017;113:43–51.

    Article  PubMed  Google Scholar 

  9. Saad F, Clarke N, Colombel M. Natural history and treatment of bone complications in prostate cancer. Eur Urol. 2006;49(3):429–40.

    Article  CAS  PubMed  Google Scholar 

  10. van Dodewaard-de Jong JM, Verheul HM, Bloemendal HJ, de Klerk JM, Carducci MA, van den Eertwegh AJ. New treatment options for patients with metastatic prostate cancer: what is the optimal sequence? Clin Genitourin Cancer. 2015;13(4):271–9.

    Article  PubMed  Google Scholar 

  11. Mercadante S. Malignant bone pain: pathophysiology and treatment. Pain. 1997;69(1–2):1–18.

    Article  CAS  PubMed  Google Scholar 

  12. Lam MG, de Klerk JM, van Rijk PP, Zonnenberg BA. Bone seeking radiopharmaceuticals for palliation of pain in cancer patients with osseous metastases. Anti Cancer Agents Med Chem. 2007;7(4):381–97.

    Article  CAS  Google Scholar 

  13. Smart JG. The use of P32 in the treatment of severe pain from bone metastases of carcinoma of the prostate. Br J Urol. 1965;37:139–47.

    Article  CAS  PubMed  Google Scholar 

  14. Porter AT, McEwan AJ, Powe JE, Reid R, McGowan DG, Lukka H, et al. Results of a randomized phase-III trial to evaluate the efficacy of strontium-89 adjuvant to local field external beam irradiation in the management of endocrine resistant metastatic prostate cancer. Int J Radiat Oncol Biol Phys. 1993;25(5):805–13.

    Article  CAS  PubMed  Google Scholar 

  15. Serafini AN, Houston SJ, Resche I, Quick DP, Grund FM, Ell PJ, et al. Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial. J Clin Oncol. 1998;16(4):1574–81.

    Article  CAS  PubMed  Google Scholar 

  16. Sartor O, Reid RH, Hoskin PJ, Quick DP, Ell PJ, Coleman RE, et al. Samarium-153-Lexidronam complex for treatment of painful bone metastases in hormone-refractory prostate cancer. Urology. 2004;63(5):940–5.

    Article  PubMed  Google Scholar 

  17. Sartor O, Hoskin P, Bruland OS. Targeted radio-nuclide therapy of skeletal metastases. Cancer Treat Rev. 2013;39(1):18–26.

    Article  CAS  PubMed  Google Scholar 

  18. Carrasquillo JA, O'Donoghue JA, Pandit-Taskar N, Humm JL, Rathkopf DE, Slovin SF, et al. Phase I pharmacokinetic and biodistribution study with escalating doses of (2)(2)(3)Ra-dichloride in men with castration-resistant metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2013;40(9):1384–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Dauer LT, Williamson MJ, Humm J, O’Donoghue J, Ghani R, Awadallah R, et al. Radiation safety considerations for the use of (2)(2)(3)RaCl(2) DE in men with castration-resistant prostate cancer. Health Phys. 2014;106(4):494–504.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Hoskin P, Sartor O, O'Sullivan JM, Johannessen DC, Helle SI, Logue J, et al. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. Lancet Oncol. 2014;15(12):1397–406.

    Article  CAS  PubMed  Google Scholar 

  21. Nilsson S, Cislo P, Sartor O, Vogelzang NJ, Coleman RE, O’Sullivan JM, et al. Patient-reported quality-of-life analysis of radium-223 dichloride from the phase III ALSYMPCA study. Ann Oncol. 2016;27(5):868–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Sartor O, Hoskin P, Coleman RE, Nilsson S, Vogelzang NJ, Petrenciuc O, et al. Chemotherapy following radium-223 dichloride treatment in ALSYMPCA. Prostate. 2016;76(10):905–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Lecouvet FE, Geukens D, Stainier A, Jamar F, Jamart J, d'Othee BJ, et al. Magnetic resonance imaging of the axial skeleton for detecting bone metastases in patients with high-risk prostate cancer: diagnostic and cost-effectiveness and comparison with current detection strategies. J Clin Oncol. 2007;25(22):3281–7.

    Article  PubMed  Google Scholar 

  24. Padhani AR, Makris A, Gall P, Collins DJ, Tunariu N, de Bono JS. Therapy monitoring of skeletal metastases with whole-body diffusion MRI. J Magn Reson Imaging. 2014;39(5):1049–78.

    Article  PubMed  Google Scholar 

  25. Fizazi K, Massard C, Smith M, Rader M, Brown J, Milecki P, et al. Bone-related parameters are the main prognostic factors for overall survival in men with bone metastases from castration-resistant prostate cancer. Eur Urol. 2015;68(1):42–50.

    Article  PubMed  Google Scholar 

  26. Parker C, Finkelstein SE, Michalski JM, O'Sullivan JM, Bruland O, Vogelzang NJ, et al. Efficacy and safety of Radium-223 dichloride in symptomatic castration-resistant prostate cancer patients with or without baseline opioid use from the phase 3 ALSYMPCA trial. Eur Urol. 2016;70(5):875–83.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Byung Ha Chung .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lee, K.S., Chung, B.H. (2018). Radiopharmaceutical Therapy in Metastatic CRPC. In: Kim, C. (eds) Management of Advanced Prostate Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-6943-7_22

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-6943-7_22

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6942-0

  • Online ISBN: 978-981-10-6943-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics