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Radium-223

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https://www.readbyqxmd.com/read/28723476/charting-recent-progress-and-challenges-in-metastatic-castration-resistant-prostate-cancer-is-there-an-optimal-treatment-sequence
#1
REVIEW
Stéphane Oudard, Pablo Maroto, Gaston Demonty, Winald R Gerritsen
CONTEXT: Recent developments in the treatment of metastatic castration-resistant prostate cancer (mCRPC) have led to uncertainty about the optimal sequence of agents. OBJECTIVE: To review and assess treatment options and sequence in patients with mCRPC. EVIDENCE ACQUISITION: To identify data on the optimal use of approved treatments, we searched PubMed for studies on the use of recently approved agents for men with mCRPC published before March 2015...
October 2016: European Urology Focus
https://www.readbyqxmd.com/read/28711312/radium-223-in-the-therapeutic-sequence-of-metastatic-castration-resistant-prostate-cancer
#2
M Unda-Urzaiz, R Sousa-Campo, A Rodríguez-Antolín, C Silva-Marins, A Juárez-Soto, B Miñana-López, A Figueiredo-de Castro, J M Cozar-Olmos
CONTEXT: Radium-223 is an □ -particle transmitter with specific action on bone metastases. The Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) study showed that radium-223 extended overall survival and delayed the onset of bone events in patients with symptomatic castration-resistant prostate cancer with bone metastases (mCRPC) and without visceral metastases, with a good safety profile. OBJECTIVE: To review the new scientific evidence on radium-223 based on prespecified and post-hoc analyses of the ALSYMPCA study and on early-access programs after the publication of the ALSYMPCA study, thereby providing new data on the management of patients with mCRPC...
July 12, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28705540/three-year-safety-of-radium-223-dichloride-in-patients-with-castration-resistant-prostate-cancer-and-symptomatic-bone-metastases-from-phase-3-randomized-alpharadin-in-symptomatic-prostate-cancer-trial
#3
Christopher C Parker, Robert E Coleman, Oliver Sartor, Nicholas J Vogelzang, David Bottomley, Daniel Heinrich, Svein I Helle, Joe M O'Sullivan, Sophie D Fosså, Aleš Chodacki, Paweł Wiechno, John Logue, Mihalj Seke, Anders Widmark, Dag Clement Johannessen, Peter Hoskin, Nicholas D James, Arne Solberg, Isabel Syndikus, Jan Kliment, Steffen Wedel, Sibylle Boehmer, Marcos Dall'Oglio, Lars Franzén, Øyvind S Bruland, Oana Petrenciuc, Karin Staudacher, Rui Li, Sten Nilsson
BACKGROUND: In Alpharadin in Symptomatic Prostate Cancer (ALSYMPCA) trial, radium-223 versus placebo prolonged overall survival with favorable safety in castration-resistant prostate cancer patients with symptomatic bone metastases. Long-term radium-223 monitoring underlies a comprehensive safety and risk/benefit assessment. OBJECTIVE: To report updated ALSYMPCA safety, including long-term safety up to 3 yr after the first injection. DESIGN, SETTING, AND PARTICIPANTS: Safety analyses from phase 3 randomized ALSYMPCA trial included patients receiving ≥1 study-drug injection (600 radium-223 and 301 placebo)...
July 10, 2017: European Urology
https://www.readbyqxmd.com/read/28700990/oncologic-response-and-hospitalization-rate-of-patients-receiving-cabazitaxel-in-the-fourth-line-and-beyond-in-castration-resistant-prostate-cancer-analysis-of-a-retrospective-cohort-and-a-structured-literature-review
#4
Jost von Hardenberg, Maike Schwartz, Thorsten Werner, Stefan Fuxius, Arne Strauss, Thomas Stefan Worst, Philipp Nuhn, Christian Bolenz, Elmar Heinrich
BACKGROUND: Limited data are available for the use of agents in metastatic castration-resistant prostate cancer (mCRPC) beyond the third-line. We provide data during treatment with cabazitaxel (CAB), helping to improve the informed-consent process. PATIENTS AND METHODS: We retrospectively reviewed patients treated with fourth-line or beyond CAB for mCRPC after failure of previous therapies with docetaxel, abiraterone acetate, enzalutamide and/or radium-223. The progression-free survival (PFS) and the overall survival (OS) were estimated using the Kaplan-Meier method and compared to published data based on a structured literature review...
July 13, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28677577/targeted-radionuclide-therapy-in-combined-modality-regimens
#5
REVIEW
Martin R Gill, Nadia Falzone, Yong Du, Katherine A Vallis
Targeted radionuclide therapy (TRT) is a branch of cancer medicine concerned with the use of radioisotopes, radiolabelled molecules, nanoparticles, or microparticles that either naturally accumulate in or are designed to target tumours. TRT combines the specificity of molecular and sometimes physical targeting with the potent cytotoxicity of ionising radiation. Targeting vectors for TRT include antibodies, antibody fragments, proteins, peptides, and small molecules. The diversity of available carrier molecules, together with the large panel of suitable radioisotopes with unique physicochemical properties, allows vector-radionuclide pairings to be matched to the molecular, pathological, and physical characteristics of a tumour...
July 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28663235/immunotherapy-of-prostate-cancer-facts-and-hopes
#6
Marijo Bilusic, Ravi A Madan, James L Gulley
In the last few years immunotherapy has become an important cancer treatment modality and while the principles of immunotherapy evolved over many decades, the FDA approvals of sipuleucel-T and ipilimumab began a new wave in immuno-oncology. Despite the current enthusiasm, it is unlikely that any of the immunotherapeutics alone can dramatically change prostate cancer outcomes, but combination strategies are more promising and provide a reason for optimism. Several completed and ongoing studies have shown that the combination of cancer vaccines or checkpoint inhibitors with different immunotherapeutic agents, hormonal therapy (enzalutamide), radiation therapy (radium 223), DNA-damaging agents (olaparib), or chemotherapy (docetaxel) can enhance immune responses and induce more dramatic, long-lasting clinical responses without significant toxicity...
June 29, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28654303/imaging-and-dosimetry-for-radium-223-the-potential-for-personalized-treatment
#7
Glenn D Flux
Radium-223 ((223)Ra) offers a new option for the treatment of bone metastases from prostate cancer. As cancer treatment progresses towards personalization, the potential for an individualized approach is exemplified in treatments with radiotherapeutics due to the unique ability to image in vivo the uptake and retention of the therapeutic agent. This is unmatched in any other field of medicine. Currently, (223)Ra is administered according to standard fixed administrations, modified according to patient weight...
June 27, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28649893/radium-223-dichloride-for-the-treatment-of-castration-resistant-prostate-cancer-with-symptomatic-bone-metastases
#8
Nicholas J Vogelzang
Castration-resistant prostate cancer (CRPC) is associated with the development of bone metastases, increased mortality, and a reduction in the patient's quality of life (QOL). The management of metastatic CRPC (mCRPC) has rapidly evolved over the past decade, with a number of available therapeutic agents improving overall survival. Radium-223 dichloride (radium-223), the first targeted alpha therapy, improves survival accompanied by QOL benefits with a favorable safety profile. It is approved in over 40 countries for the treatment of patients with CRPC with symptomatic bone metastases and no known visceral metastatic disease...
July 3, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28644302/the-role-of-bone-targeted-therapies-for-prostate-cancer-in-2017
#9
Samer L Traboulsi, Fred Saad
PURPOSE OF REVIEW: Bone-targeted agents (BTAs), such as zoledronic acid and denosumab, delay the occurrence of skeletal-related events (SREs) in metastatic prostate cancer (PCa) patients. Recently, several agents, such as abiraterone acetate, enzalutamide and radium-223, were approved for the treatment of metastatic castration-resistant PCa (mCRPC). These agents resulted in improved overall survival (OS), pain control and had positive effects on bone health. Combining BTAs to the newly approved agents demonstrates additional benefits that warrant a review of available evidence looking at appropriate combination therapies and timing of BTAs for optimizing the management of advanced and metastatic PCa...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28631036/practical-recommendations-for-radium-223-treatment-of-metastatic-castration-resistant-prostate-cancer
#10
Yong Du, Ignasi Carrio, Giuseppe De Vincentis, Stefano Fanti, Harun Ilhan, Caroline Mommsen, Egbert Nitzsche, Francis Sundram, Wouter Vogel, Wim Oyen, Val Lewington
PURPOSE: Radium Ra 223 dichloride (radium-223, Xofigo®) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. METHODS: An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223...
June 19, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28614883/-monitoring-of-treatment-for-metastatic-castration-resistant-prostate-cancer
#11
Stefan Hinz
Treatments currently available for metastatic castration-resistant prostate cancer (mCRPC) include abiraterone acetate, enzalutamide, docetaxel, cabazitaxel, and radium-223. However, the optimal sequence of these agents is still unclear, and markers to predict treatment response and facilitate patient selection remain an unmet need. In terms of overall survival, it is crucial that patients receive all treatment options currently available. This requires early detection of progression as an indication for a treatment switch...
May 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28577511/therapies-for-castration-resistant-prostate-cancer-in-a-new-era-the-indication-of-vintage-hormonal-therapy-chemotherapy-and-the-new-medicines
#12
REVIEW
Atsushi Mizokami, Yoshifumi Kadono, Yasuhide Kitagawa, Kouji Izumi, Hiroyuki Konaka
When advanced prostate cancer recurred during hormonal therapy and became the castration-resistant prostate cancer, "vintage hormonal therapy," such as antiandrogen alternating therapy or estrogen-related hormonal therapy, was widely carried out in Japan until 2013. This vintage hormonal therapy controlled the progression of castration-resistant prostate cancer. When castration-resistant prostate cancer relapses during these therapies, chemotherapy using docetaxel has been carried out subsequently. Since new hormonal therapies using abiraterone acetate and enzalutamide, which improve the prognosis of castration-resistant prostate cancer, became available in Japan from 2014, therapeutic options for castration-resistant prostate cancer have increased...
June 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28546330/exploring-new-multimodal-quantitative-imaging-indices-for-the-assessment-of-osseous-tumour-burden-in-prostate-cancer-using-68-ga-psma-pet-ct
#13
Marie Bieth, Markus Krönke, Robert Tauber, Marielena Dahlbender, Margitta Retz, Stephan G Nekolla, Bjoern Menze, Tobias Maurer, Matthias Eiber, Markus Schwaiger
Positron-emission-tomography (PET) combined with computed-tomography (CT) and prostate-specific-membrane-antigen (PSMA) ligands has gained significant interest for staging prostate cancer (PC). In this study, we propose two multimodal quantitative indices as imaging biomarker for the assessment of osseous tumour burden using (68)Ga-PSMA-PET/CT and present preliminary clinical data. We define two Bone-PET-Indices (BPI) that incorporate anatomical information from CT and functional information from (68)Ga-PSMA-PET: BPIVOL is the percental bone volume affected by tumour...
May 25, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28545997/factors-associated-with-survival-following-radium-223-treatment-for-metastatic-castration-resistant-prostate-cancer
#14
William W Wong, Eric M Anderson, Homan Mohammadi, Thomas B Daniels, Steve E Schild, Sameer R Keole, C Richard Choo, Katherine S Tzou, Alan H Bryce, Thai H Ho, Fernando J Quevedo, Sujay A Vora
BACKGROUND: Radium-223 ((223)Ra) improves survival in patients with metastatic castration-resistant prostate cancer (mCRPC). This retrospective analysis was performed to better understand its efficacy in routine clinical practice and identify factors associated with survival. MATERIALS AND METHODS: Sixty-four patients with mCRPC who received (223)Ra between 2013 and 2015 were the basis of this retrospective study. Clinical outcomes and patient characteristics were obtained...
April 26, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28527407/mechanisms-of-resistance-to-systemic-therapy-in-metastatic-castration-resistant-prostate-cancer
#15
REVIEW
Giuseppe Galletti, Benjamin I Leach, Linda Lam, Scott T Tagawa
Patients with metastatic castration-resistant prostate cancer (mCPRC) now have an unprecedented number of approved treatment options, including chemotherapies (docetaxel, cabazitaxel), androgen receptor (AR)-targeted therapies (enzalutamide, abiraterone), a radioisotope (radium-223) and a cancer vaccine (sipuleucel-T). However, the optimal treatment sequencing pathway is unknown, and this problem is exacerbated by the issues of primary and acquired resistance. This review focuses on mechanisms of resistance to AR-targeted therapies and taxane-based chemotherapy...
June 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28503903/the-23rd-annual-prostate-cancer-foundation-scientific-retreat-report
#16
REVIEW
Andrea K Miyahira, Howard R Soule
INTRODUCTION: The 23rd Annual Prostate Cancer Foundation (PCF) Scientific Retreat was convened October 27-29, 2016, in Carlsbad, CA. METHODS: This event focuses on the latest advances in basic, translational, and clinical prostate cancer research with the greatest promise for advancing our understanding of prostate cancer biology and improving patient outcomes and quality of life. RESULTS: Themes highlighted at this year's meeting included: i) targeting DNA repair deficiency in prostate cancer; ii) optimizing the use of Radium-223 and bone-targeting agents; iii) advances in cancer immunotherapeutic approaches; iv) targeting developmental pathways in prostate cancer; v) advances in circulating tumor DNA technology and applications; vi) precision survivorship; and vii) novel treatments and treatment strategies in prostate cancer...
May 14, 2017: Prostate
https://www.readbyqxmd.com/read/28484088/radium-223-for-primary-bone-metastases-in-patients-with-hormone-sensitive-prostate-cancer-after-radical-prostatectomy
#17
Vera Wenter, Annika Herlemann, Wolfgang P Fendler, Harun Ilhan, Natalia Tirichter, Peter Bartenstein, Christian G Stief, Christian la Fougère, Nathalie L Albert, Axel Rominger, Christian Gratzke
Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Ten patients with primary bone metastases received Ra-223 following radical prostatectomy (RP). Changes in alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were recorded, while pain intensity was evaluated using the self-reporting Brief Pain Inventory (BPI) questionnaire...
July 4, 2017: Oncotarget
https://www.readbyqxmd.com/read/28453701/an-exploratory-analysis-of-alkaline-phosphatase-lactate-dehydrogenase-and-prostate-specific-antigen-dynamics-in-the-phase-3-alsympca-trial-with-radium-223
#18
O Sartor, R E Coleman, S Nilsson, D Heinrich, S I Helle, J M O'Sullivan, N J Vogelzang, Ø Bruland, S Kobina, S Wilhelm, L Xu, M Shan, M W Kattan, C Parker
Background: Baseline clinical variables are prognostic for overall survival (OS) in patients with castration-resistant prostate cancer (CRPC). Their prognostic and predictive value with agents targeting bone metastases, such as radium-223, is not established. Patients and methods: The radium-223 ALSYMPCA trial enrolled patients with CRPC and symptomatic bone metastases. Prognostic potential of baseline variables was assessed using Cox models. Percentage changes in biomarker levels from baseline were evaluated during the trial period; changes from baseline to week 12 were evaluated for association with OS and surrogacy...
May 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28449621/emerging-role-of-radium-223-in-the-growing-therapeutic-armamentarium-of-metastatic-castration-resistant-prostate-cancer
#19
Maria Picciotto, Tindara Franchina, Alessandro Russo, Giuseppina Rosaria Rita Ricciardi, Giusy Provazza, Serena Sava, Sergio Baldari, Orazio Caffo, Vincenzo Adamo
During the last few years, the therapeutic armamentarium of castration resistant prostate cancer (mCRPC) has been enriched with the introduction of new effective therapies with proved survival benefit and quality of life gain, including cabazitaxel, abiraterone, enzalutamide, and Radium-223. Areas covered: Bone metastases represent a substantial cause of morbidity in mCRPC with a high rate of related skeletal events (SREs). In case of multifocal pain due to diffuse osteoblastic metastases, treatment with bone-targeting radiopharmaceutical agents can provide palliation from pain...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28441112/second-line-hormonal-therapy-for-men-with-chemotherapy-na%C3%A3-ve-castration-resistant-prostate-cancer-american-society-of-clinical-oncology-provisional-clinical-opinion
#20
Katherine S Virgo, Ethan Basch, D Andrew Loblaw, Thomas K Oliver, R Bryan Rumble, Michael A Carducci, Luke Nordquist, Mary-Ellen Taplin, Eric Winquist, Eric A Singer
Purpose ASCO provisional clinical opinions (PCOs) offer direction to the ASCO membership after publication or presentation of potential practice-changing data. This PCO addresses second-line hormonal therapy for chemotherapy-naïve men with castration-resistant prostate cancer (CRPC) who range from being asymptomatic with only biochemical evidence of CRPC to having documented metastases but minimal symptoms. Clinical Context The treatment goal for CRPC is palliation. Despite resistance to initial androgen deprivation therapy, most men respond to second-line hormonal therapies...
June 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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