ALSYMPCA: alpha emitter radium-223 and survival in metastatic prostate cancer with bone metastases
Radium-223, an injected alpha-emitting radioisotope that homes to bone, lengthened survival and delayed skeletal complications in men with castration-resistant prostate cancer that had spread to bone but not to organs.
Overview
Phase 3 placebo-controlled trial of 921 men with castration-resistant prostate cancer, symptomatic bone metastases and no visceral disease, randomised 2:1 to six injections of radium-223 or placebo with best standard of care.
Median overall survival was 14.9 versus 11.3 months (hazard ratio 0.70), time to first symptomatic skeletal event was delayed (15.6 versus 9.8 months) and myelosuppression was mild.
- Median overall survival 14.9 vs 11.3 months; hazard ratio 0.70.
- Time to first symptomatic skeletal event 15.6 vs 9.8 months.
Radium-223 is an option for symptomatic bone-predominant castration-resistant prostate cancer, now less used since lutetium-PSMA, and should not be combined with abiraterone after the ERA 223 fracture signal.
- No effect on PSA or soft tissue disease.
- Combination with abiraterone increased fractures and deaths in ERA 223.
Similar pages
not linked directly; found by shared links- Key paperCOU-AA-301: abiraterone and increased survival in metastatic castration-resistant prostate cancer after docetaxel
Shares Metastatic castration-resistant prostate cancer, New England Journal of Medicine.
- Key paperPROfound: olaparib for metastatic castration-resistant prostate cancer with homologous recombination repair gene alterations
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- TreatmentRadium-223 dichloride
Shares ALSYMPCA, Metastatic castration-resistant prostate cancer.
- Key paperVISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer
Shares Metastatic castration-resistant prostate cancer, New England Journal of Medicine.