Vogelzang, MD, a genitourinary oncologist at Comprehensive Cancer Centers of Nevada, Las Vegas, “In general, about half of say they will not take chemotherapy. The availability of radium-223 offers a novel therapeutic alternative for patients with CRPC and bone metastasis, particularly for those who wish to avoid the side effects of chemotherapy.
#RADIUM 223 HOW TO#
Petrylak, MD, Director of the Genitourinary Oncology Program at the Yale Cancer Center, New Haven, CT, noted that radium-223 “is the first isotope to show a survival benefit ….Now we need to do the studies to know how to best sequence these drugs.” 14 In an interview regarding this new radiopharmaceutical, Daniel P. 13 The improvement in OS was supported by a delay in time to the first symptomatic skeletal-related event favoring the radium-223 arm.
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00185) improvement in median OS compared with placebo plus best standard of care. 12 In a prespecified interim analysis, radium Ra 223 dichloride (radium-223) combined with best standard of care demonstrated a significant 3.2-month (hazard ratio, 0.70 95% confidence interval, 0.55-0.88 P =. In May 2013, the FDA approved radium Ra 223 dichloride (Xofigo Injection Bayer HealthCare Pharmaceuticals) for the treatment of patients with castration-resistant prostate cancer (CRPC) plus symptomatic bone metastases and no known visceral metastatic disease. 9-11įDA Approves Xofigo for Metastatic CRPC with Bone Metastasis 7,8īy contrast, sipuleucel-T (Provenge), abiraterone (Zytiga), and enzalutamide (Xtandi) have demonstrated advantages in OS in patients with metastatic prostate cancer, but these agents do not target disease that has spread to bone and are not indicated specifically for patients with prostate cancer plus bone metastases. Both were approved by the US Food and Drug Administration (FDA) on the basis of randomized phase 3 clinical trials that demonstrated an improvement in pain in patients with metastatic prostate cancer. The 2 radiopharmaceuticals, strontium-89 and samarium-153 EDTMP, are beta-particle emitters. None of these 4 agents has been proved to prolong overall survival (OS) in large phase 3 randomized trials. 6Ĭurrently, 4 bone-targeted therapies are available for men with prostate cancer, including zoledronic acid (Zometa), denosumab (Prolia), samarium-153 ethylene diamine tetramethylene phosphonate (EDTMP Quadramet), and strontium-89 (Metastron). More than 2.5 million American men are currently living with prostate cancer. Unmet Need in Patients with Prostate Cancer and Bone MetastasesĪccording to the National Cancer Institute, in 2013, more than 238,500 men will be diagnosed with prostate cancer and more than 29,700 will die from the disease. A retrospective, observational study using health insurance claims data for episodes of care from September 2002 to June 2011 demonstrated that, among patients with prostate cancer, the cost of a skeletal-related event ranged from approximately $11,700 for an outpatient episode to more than $54,000 for an inpatient episode. Patients with prostate cancer and bone metastases utilize an inordinate amount of healthcare resources. 4 The prostate cancer–related costs made up approximately 31% of the total costs, or more than $34,000 per patient. The model estimated total lifetime medical costs of approximately $110,500 per patient (in 2004 US dollars). These cost estimates were then combined with survival data to determine the total lifetime costs and the prostate cancer–related lifetime costs. The medical cost data were obtained from the SEER-Medicare database and were estimated during specific phases of cancer care. Using Surveillance, Epidemiology and End Results (SEER) data, Stokes and colleagues estimated the survival of men aged ≥65 years who were diagnosed with prostate cancer between the calendar years of 19. Prostate cancer places a significant burden on the US healthcare system. 2īone metastases have serious and debilitating clinical consequences, including pain that requires opioids and/or radiotherapy, hypercalcemia, pathologic fracture, spinal cord compression, and nerve root compression. 1 The median survival after the diagnosis of bone metastasis associated with prostate cancer is approximately 3 years. Among patients with metastatic prostate cancer, up to approximately 90% have bone metastases. Prostate cancer is the second leading cause of cancer-related death in the United States among men and the most frequently diagnosed cancer in American males.
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