Use of Radium-223 for Symptomatic mCRPC with or without Prior Docetaxel
Efficacy and Safety of Radium-223 Dichloride in Patients with Castration-resistant Prostate Cancer and Symptomatic Bone Metastases, with or without Previous Docetaxel use: A Prespecified Subgroup Analysis from the Randomised, Double-blind, Phase 3 ALSYMPCA Trial
Dr. Oliver Sartor presents the outcomes of a prespecified subgroup analysis from the ALpharadin in SYMptomatic Prostate CAncer patients (ALSYMPCA) trial. This subgroup analysis evaluated the efficacy and safety of Radium-223 dichloride (Ra-223) when used in patients with CRPC and symptomatic bone metastases, with or without prior docetaxel use.
Dr. Sartor explains that Radium-223 is a novel targeted α-emitter that selectively binds to areas of increased metabolic activity in bone metastases. Further, he summarizes the phase 3 ALSYMPCA trial that compared efficacy and safety of Radium-223 plus best standard of care versus placebo plus best standard of care in patients with castration-resistant prostate cancer and symptomatic bone metastases.
The primary outcome in the ALSYMPCA trial was overall survival (OS): Radium-223 significantly improved the median OS compared to placebo with 14.9 months vs. 11.3 months, a 3.6 months advantage in favor of Radium-223.
Of the 921 patients included in the trial, 526 (57%) had received previous docetaxel while 395 (43%) had not, explains Dr. Sartor. When the subgroup analysis in this trial was completed, it showed that Ra-223 prolonged median OS and improved most secondary endpoints compared with placebo, irrespective of previous docetaxel use. In addition, Radium-223 had a favorable safety profile with a low incidence of myelosuppression, irrespective of docetaxel subgroup. Dr. Sartor concludes that Radium-223 is an effective and well-tolerated treatment in men with CRPC and symptomatic bone metastases, irrespective of prior docetaxel use.
Participating in Dr. Sartor’s 13-minute video provides you the authors’ perspective of the phase 3 ALSYMPCA trial, including this subgroup analysis, and an understanding of the patient characteristics for the men suitable for treatment with Radium-223.
Oliver Sartor, MD
Medical Director, Tulane Cancer Center
C.E. and Bernadine Laborde Professor of Cancer Research
Department of Medicine: Section of Hematology & Medical Oncology and Department of Urology
Dr. Oliver Sartor is the C.E. and Bernadine Laborde Professor of Cancer Research in the Departments of Medicine and Urology at Tulane University School of Medicine. He is a medical oncologist with an interest in prostate cancer from both a basic and clinical perspective. He is on the Department of Defense Integration Panel for prostate cancer research and is the chairman-elect of the organization as well as co-editor-in-chief of the peer-reviewed journal Clinical Genitourinary Cancer. He is also the current medical oncology chair of the Radiation Oncology Treatment Group Genitourinary Cancer Committee. In addition, Dr. Sartor is a SPORE project co-PI at Dana-Farber Cancer Center on a translational project involving the clinical outcomes and consequences of the 8q24 risk alleles. Dr. Sartor's current research interests include clinical trials in advanced prostate cancer with novel agents and novel combinations of agents. His collaborative projects include novel concepts in prostate stem cells and germ line assessment of prostate cancer risk.