Radium-223 in the Modern Treatment of Metastatic Castration-resistant Prostate Cancer

Abstract

The objective: is to determine the current role of radium-223 in the emergence of new options in the treatment of patients with metastatic castration-resistant prostate cancer.
 Materials and methods. Studies of ERA-223 and ALSYMPCA have identified the role of radium-223 in the treatment of prostate cancer and its impact on human health.
 Results. In one such study, ERA-223, it was shown that the combination of abiraterone with radium-223 did not increase survival without symptomatic skeletal events compared with abiraterone plus placebo. In addition, a higher incidence of bone fractures was observed with the combination of abiraterone and radium-223, especially in patients not receiving osteomodulators (denosumab or zoledronic acid). These results have led to some changes in the indications for the use of radium-223 in Europe and more careful attention to the state of bone structure in patients with prostate cancer.
 An overview of expert recommendations for the prevention and treatment of bone events, as well as the consequences of prolonged targeted therapy in patients with metastatic prostate cancer, which may improve the results of general and cancer-specific survival. Radium-223 has been shown to be an important option for patients with castration-resistant prostate cancer with bone metastases, and monitoring and maintaining bone health is an important factor in prostate cancer patients. It is established that the treatment of this category of patients should begin with androge n deprivation therapy.
 Conclusions. A review of the recommendations of urologists, oncologists and radiation oncologists in Europe, who specialize in the treatment of patients with advanced prostate cancer, to maintain bone health, treatment consequences and the role of radium-223 in the treatment of prostate cancer. Based on the analysis of the use of radium-223 in the current treatment of CRPD, preventive measures to maintain bone health are recommended, as well as side effects based on clinical experience.