Radium-223 for the Management of Bone Metastases in Castration-Resistant Prostate Cancer

© 2015 Harborside Press® In the United States, prostate cancer is the most common cancer and second leading cause of cancer-related deaths in men. It is estimated that 220,800 new cases of prostate cancer will have been diagnosed in 2015, with an estimated 27,540 deaths (American Cancer Society, 2015). Although prostate cancer is typically diagnosed when it is localized and considered curable, approximately 4% of patients have metastatic cancer at diagnosis. For androgen-sensitive metastatic disease, the current standard of care is continuous androgen-deprivation therapy (National Comprehensive Cancer Network, 2015). However, a large proportion of patients progress to metastatic castration-resistant prostate cancer (CRPC) and require additional therapy. Over 90% percent of patients with metastatic CRPC develop bone metastases (Bubendorf et al., 2000). As the vast majority of patients with metastatic CRPC have bone metastases, there is an increase in morbidity and mortality due to skeletal-related events. Over the past decade, several treatment options have demonstrated a survival benefit in metastatic CRPC, including abiraterone (Zytiga), docetaxel, cabazitaxel (Jevtana), sipuleucel-T (Provenge), and enzalutamide (Xtandi; Wissing, van Leeuwen, van der Pluijm, & Gelderblom, 2013). Radium-223 dichloride (Xofigo) is a newly approved agent that specifically targets bone metastases in metastatic CRPC.