Treating Symptomatic Bone Metastatic CRPC

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Radium-223 is an alpha particle-emitting radioactive therapeutic agent that was approved by the FDA in 2013 and is indicated for the treatment of patients with CRPC, symptomatic bone metastases, and no known visceral metastatic disease.

Oliver Sartor, MD, explains that radium-223 is a high energy particle that is a natural calcium-mimetic agent. Radium-223 is dosed by weight and given as 1 dose every 4 weeks for a total of 6 doses. When injected into the bloodstream, radium-223 is taken up in areas of osteoblastic metastasis; the short range of action of radium-223 minimizes myelosuppression.

The efficacy of radium-223 was evaluated in the ALSYMPCA trial; the results of the trial showed that radium-223 prolonged overall survival and had palliative effects. Kenneth Kernen, MD, remarks that in his practice, patients who received radium-223 experienced symptom relief with low toxicity.