The Clinical Efficacy of Radium-223 for Bone Metastasis in Patients with Castration-Resistant Prostate Cancer: An Italian Clinical Experience

Background/Aim: Prostate cancer frequently causes bonemetastases and skeletal events that impair quality of life(QoL) and survival. The alpha emitter radium-223 is a newdrug that improves treatment in men with castration-resistant prostate cancer (CRPC) and bone metastases. Our aimwas to evaluate the effectiveness of radium-223. Subjectsand Methods: In this retrospective study we enrolled 48 subjects. Pain reduction, alkaline phosphatase (ALP), time to firstsymptomatic skeletal event, and QoL were the variables weevaluated. Results: Radium-223 was well tolerated, with amanageable toxicity profile and a modest objective response rate. A considerable difference in serum ALP levelsbefore and after treatment was observed, with a significantcorrelation between pain relief and QoL, which showed avalue of R2 to 0.44 with a slope of 1.50 (p = 0.0021). Conclusions: Radium-223 showed a clinical benefit, with a reduction in pain symptoms in 58% of patients. Radium-223 was shown to be an effective and well-tolerated therapeuticoption in patients with metastatic CRPC progressing afterdocetaxel plus prednisone treatment.