Outcomes and patterns of use of Radium-223 in metastatic castration-resistant prostate cancer.

Autor:	Anido-Herranz U; Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.; Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain., Fernandez-Calvo O; Department of Medical Oncology, University Clinical Hospital of Ourense, Ourense, Spain., Ruiz-Bañobre J; Translational Medical Oncology Group (ONCOMET), Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.; Department of Medical Oncology, University Clinical Hospital of Santiago de Compostela (SERGAS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain.; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain., Martinez-Breijo S; Department of Urology, University Clinical Hospital of A Coruña, A Coruña, Spain., Fernandez-Nuñez N; Department of Medical Oncology, Lucus Augusti University Hospital, Lugo, Spain., Nogareda-Seoane Z; Department of Nuclear Medicine, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Garrido-Pumar M; Department of Nuclear Medicine, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Casas-Nebra J; Department of Urology, Lucus Augusti University Hospital, Lugo, Spain., Muñiz-Garcia G; Department of Nuclear Medicine - GALARIA, Complexo Hospitalario Universitario Ourense A. S. de Ourense, Ourense, Spain., Portela-Pereira P; Department of Urology, Area Sanitaria de Ourense, Ourense, Spain., Gomez-Caamaño A; Department of Radiation Oncology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Perez-Fentes DA; Department of Urology, EOXI University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Santome-Couto L; Department of Medical Oncology, POVISA, Vigo, Spain., Lázaro M; Department of Medical Oncology, Álvaro Cunqueiro Hospital, Vigo, Spain., Molina-Diaz A; Department of Medical Oncology, University Clinical Hospital of A Coruña, A Coruña, Spain., Medina-Colmenero A; Department of Medical Oncology, Fundación Centro Oncológico de Galicia, A Coruña, Spain., Vazquez-Estevez S; Department of Medical Oncology, Lucus Augusti University Hospital, Lugo, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 May 07; Vol. 14, pp. 1385466. Date of Electronic Publication: 2024 May 07 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1385466
Abstrakt:	Introduction: Radium-223 dichloride (Ra-223) is recommended as a treatment option for metastatic castration-resistant prostate cancer (mCRPC) patients with symptomatic bone metastases and no visceral disease, after docetaxel failure, or in patients who are not candidates to receive it. In this study, we aimed to ambispectively analyze overall survival (OS) and prognostic features in mCRPC in patients receiving Ra-223 as per clinical routine practice and identify the most suitable treatment sequence. Patients and Methods: This study is observational, multicentric, and ambispective. Eligibility criteria included mCRPC patients treated with Ra-223, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2, without visceral metastases, and no more than three cm involved lymph nodes. Results: A total of 145 patients were included; the median age was 73.97 years, and a Gleason score of more than or equal to 7 in 61 (48%) patients; 73 (81%) had previously received docetaxel. The most important benefit was reached by those patients who received Ra-223 in the second-line setting, with a median OS of 17 months (95% CI, 12-21), and by patients who received six cycles of treatment, with a median OS of 19 months (95% CI, 14-21). An alkaline phosphatase (ALP) decrease was also identified as a prognosis marker. When performing the multivariate analysis, the time to develop castration-resistant disease longer than 24 months was the most important prognostic factor to predict the evolution of the patients receiving Ra-223. Ra-223 was well tolerated, with thrombocytopenia, anemia, and diarrhea being the main adverse events. Conclusion: There is a benefit for those patients who received Ra-223 in the second-line setting, regardless of prior use of docetaxel. In addition, a survival benefit for patients presenting with a decline in ALP was observed. Competing Interests: UA-H — Consultant or advisory board: Advanced Accelerator Applications, Ipsen, Astra Zeneca, Merck, Pfizer, Astellas, Bayer, MSD, BMS; travel support: Ipsen, Bayer, Merck, Pfizer, GSK, Roche, Sanofi, Advanced Accelerator Applications; honoraria: Advanced Accelerator Applications, Ipsen, Astra Zeneca, Merck, Eisai, BMS, Rovi, Grünenthal Pharma, Leo Pharma an inmediate family member. JC-N — Consultant: Janssen, BMS; honoraria as speaker: Astellas, Bayer, Janssen. OF-C — Consultant or Advisory role: Astellas, BMS, Ipsen, Merck, Eisai; Honoraria as speaker: Novartis, BMS, Ipsen, Roche, Astellas, Bayer. NF-N — Advisory board: Pfizer; speaking honoraria: Ipsen, Roche, Bayer. AG-C — Scientific advice to Astellas, AstraZeneca, Bayer, Ipsen, Janssen; honoraria and consulting from Astellas, AstraZeneca, Bayer, Ipsen, Janssen; travel and lodging support from Astellas, AstraZeneca, Bayer, Ipsen, Janssen. ML — Consultant or AdvisoryRole: BMS, MSD, Takeda, Pfizer, Roche, Ipsen, Astra–Zéneca, Merck, Boehringer, Bayer, Novartis, AAA; speaking: Roche, Ipsen, MSD, Lilly, Astellas, Janssen, Novartis, Boehringer; grant or travel support: MSD, Ipsen, Roche, Janssen, Pfizer, Astellas, Pierre–Fabré; participation in clinical trials: Merck, Astellas, Pfizer, Ipsen, Roche, AstraZeneca, Mirati, PharmaMar. SM-B — Advisory role: Bayer, AstraZeneca, Astellas; Honoraria as speaker: Bayer, AstraZeneca, Novartis, Astellas, Janssen, Amgen. AM-D — Honoraria: Eisai, Grünenthal Pharma, Kyowa Kirin, Pharmamar, Merck, BMS, Roche, Ipsen; travel, accommodation, and congress: Pfizer, BMS, MSD, Eisai, Kyowa Kirin, Merck, Pharmamar, AstraZeneca, Lilly, Sanofi, Takeda, Astellas, Roche, Pierre Fabre; advisory board: Bayer, Eisai, Pierre Fabre, Pharmamar, Pfizer, Merck, Astellas, BMS. DP-F — Honoraria as consultant: Astellas, Bayer, Janssen; honoraria as speaker: Astellas, Bayer, Janssen, Ipsen; travel, accomodations and expenses: Astellas, Bayer, Janssen, Ipsen. JR-B — Travel, accommodations, and expenses: Merck, Pierre–Fabre, Sanofi, and Seagen; honoraria for educational activities: Ipsen; institutional research funding: Nouscom, Pfizer, and Roche. SV-E — Honoraria as consultant and advisory boards: Pfizer, Astellas, Janssen, MSD, Bayer, Roche, BMS, AztraZeneca, Ipsen, Organon and Merck; honoraria as speaker: Lilly, Astellas, Bayer, Roche, Ipsen, Janssen, Takeda, Merck, Organon and AstraZeneca; Travel grants: Pfizer, Roche, Ipsen and AstraZeneca. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Anido-Herranz, Fernandez-Calvo, Ruiz-Bañobre, Martinez-Breijo, Fernandez-Nuñez, Nogareda-Seoane, Garrido-Pumar, Casas-Nebra, Muñiz-Garcia, Portela-Pereira, Gomez-Caamaño, Perez-Fentes, Santome-Couto, Lázaro, Molina-Diaz, Medina-Colmenero and Vazquez-Estevez.)
Databáze:	MEDLINE
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