Is radium-223 a game-changer for treatment of CRPC with symptomatic bone metastases?

This week, the FDA approved radium-223 injection for the treatment of castration-resistant prostate cancer (CRPC) with symptomatic bone metastases.

It is the first FDA-approved alpha particle-emitting radioactive therapeutic agent. In a pivotal phase 3 trial, the median overall survival time was 14.9 months for patients who received the drug compared with 11.3 months among placebo recipients, a significant difference that translated into a 31% decreased risk death associated with radium-223 therapy.

Radium-223 mimics calcium and forms complexes with hydroxyapatite, a bone mineral, at areas of increased bone turnover, such as bone metastases. Here, the alpha particles exert their anti-tumor effect on cancer cells. Alpha particles have an extremely short range, which helps to limit damage to surrounding normal tissue.

Renal & Urology News would like to know what urologists think about this latest addition to the PCa armamentarium, so please answer the following online poll question.


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