Preview

Cancer Urology

Advanced search

Modern approaches to treatment of castration-resistant prostate cancer using targeted radionuclide therapy in patients with bone metastases

https://doi.org/10.17650/1726-9776-2024-20-4-132-138

Abstract

Treatment of metastatic castration-resistant prostate cancer (mCRPC) is an important problem. At this disease stage, some of the most pronounced symptoms worsening the quality of life develop: bone metastases-associated pain and pathological fractures. As a rule, mCRPC causes death due to prostate cancer progression. One of the 2nd line pharmaceuticals to treat mCRPC is Radium-223 dichloride [223Ra]. The use of Radium-223 increases overall survival, decreases the size, and in some cases, the number of metastatic lesions in the bones, decreases the intensity of pain syndrome and consequently the need for analgesics including narcotics. Radium-223 has a favorable safety profile and is tolerated well by the majority of patients. The review presents real clinical data on the use of Radium-223 in various countries including Russia and a network meta-analysis on the safety of mCRPC therapy using Radium-223 in combination with new antiandrogens.

About the Authors

V. M. Perepukhov
National Medical Research Radiological Center, Ministry of Health of Russia
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284


Competing Interests:

None



B. Ya. Alekseev
National Medical Research Radiological Center, Ministry of Health of Russia; Medical Institute of Continuing Education, Russian Biotechnological University
Russian Federation

3 2nd Botkinskiy Proezd, Moscow 125284; 11 Volokolamskoe Shosse, Moscow 125080


Competing Interests:

None



K. M. Nyushko
National Medical Research Radiological Center, Ministry of Health of Russia; Medical Institute of Continuing Education, Russian Biotechnological University
Russian Federation

Kirill M. Nyushko.

3 2nd Botkinskiy Proezd, Moscow 125284; 11 Volokolamskoe Shosse, Moscow 125080


Competing Interests:

None



References

1. Shakhzadova A.O., Starinsky V.V., Lisichnikova I.V. Cancer care to the population of Russia in 2022. Sibirskiy onkologicheskiy zhurnal = Siberian Journal of Oncology 2023;22(5):5–13. (In Russ.).

2. Freedland S.J., Humphreys E.B., Mangold L.A. et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA 2005;294(4):433–9. DOI: 10.1001/jama.294.4.433

3. Kupelian P.A., Buchsbaum J.C., Elshaikh M. et al. Factors affecting recurrence rates after prostatectomy or radiotherapy in localized prostate carcinoma patients with biopsy Gleason score 8 or above. Cancer 2002;95(11):2302–7. DOI: 10.1002/cncr.10977

4. Prostate cancer. Clinical guidelines. Ministry of Health of Russia, 2021. (In Russ.).

5. Gallaher J., Cook L.M., Gupta S. et al. Improving treatment strategies for patients with metastatic castrate resistant prostate cancer through personalized computational modeling. Clin Exp Metastasis 2014;31:991–9. DOI: 10.1007/s10585-014-9674-1

6. Kirby M., Hirst C., Crawford E.D. Characterising the castration-resistant prostate cancer population: a systematic review. Int J Clin Pract 2011;65(11):1180–92. DOI: 10.1111/j.1742-1241.2011.02799.x

7. Bubendorf L., Schöpfer A., Wagner U. et al. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol 2000;31(5):578–83. DOI: 10.1053/hp.2000.6698

8. Smith M., Parker C., Saad F. et al. Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer and bone metastases (ERA 223): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2019;20(3):408–19. DOI: 10.1016/S1470-2045(18)30860-X

9. Parker C., Nilsson S., Heinrich D. et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013;369(3):213–23. DOI: 10.1056/NEJMoa1213755

10. Alekseev B.Ya., Tombal’ B., Kel’n A.A. Prostate cancer in disabled settings. Onkourologiya = Cancer Urology 2021;17(4):112–4. (In Russ.). DOI: 10.17650/1726-9776-2021-17-4-112-114

11. Gillessen S. Presented at: European Society for Medical Oncology Congress; September 13–17, 2024; Barcelona, Spain. Abstract LBA1.

12. Maughan B.L., Kessel A., McFarland T.R. et al. Radium-223 plus enzalutamide versus enzalutamide in metastatic castration-refractory prostate cancer: final safety and efficacy results. Oncologist 2021;26(12):1006–e2129. DOI: 10.1002/onco.13949

13. Morris M.J., De Wit R., Vogelzang N.J. et al. A phase III trial of docetaxel versus docetaxel and radium-223 (Ra-223) in patients with metastatic castration-resistant prostate cancer (mCRPC): DORA. J Clin Oncol 2021;39:TPS5091.

14. Bruland Ø.S., Nilsson S., Fisher D.R., Larsen R.H. et al. High-linear energy transfer irradiation targeted to skeletal metastases by the α-emitter 223Ra: adjuvant or alternative to conventional modalities? Clin Cancer Res 2006;12(20):6250s–7s. DOI: 10.1158/1078-0432.CCR-06-0841

15. Kerr C. (223)Ra targets skeletal metastases and spares normal tissue. Lancet Oncol 2002;3(8):453. DOI: 10.1016/s1470-2045(02)00835-5

16. Hyväkkä A., Kääriäinen O.S., Utriainen T. et al. Radium-223 dichloride treatment in metastatic castration-resistant prostate cancer in Finland: A real-world evidence multicenter study. Cancer Med 2023;12(4):4064–76. DOI: 10.1002/cam4.5262

17. Matsumoto T. Effectiveness and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and bone metastases in real-world practice: a multi-institutional study. Int J Urol 2023;30(2):139–46.

18. Zhang H. Survival and fracture risk with radium-223 therapy in metastatic castrate-resistant prostate cancer (mCRPC): a real-world analysis. J Clin Oncol 2024;42:50.

19. Yurmazov Z.A., Usynin E.A., Medvedeva A.A. et al. Clinical experience of using the radium-223 in patients with bone metastasis of castration-resistant prostate cancer. Onkourologiya = Cancer Urology 2022;18(1):70–6. (In Russ.). DOI: 10.17650/1726-9776-2022-18-1-70-76

20. Van der Doelen M.J., Oving I.M., Wyndaele D.N.J. et al. Health-related quality of life, psychological distress, and fatigue in metastatic castration-resistant prostate cancer patients treated with radium-223 therapy. Prostate Cancer Prostatic Dis 2023;26(1):142–50. DOI: 10.1038/s41391-022-00569-8

21. Kit O.I., Maksimova N.A., Gusareva M.A. et al. Intravenous radionuclide therapy with radium chloride [223Ra] in patients with bone metastases from castration-resistant prostate cancer. Yuzhno-Rossiyskiy onkologicheskiy zhurnal = South Russian Journal of Cancer 2024;5(4):6–13. (In Russ.). DOI: 10.37748/2686-9039-2024-5-4-1

22. Matveev V.B., Markova A.S. Efficacy and safety of radium-223 in routine clinical practice. Onkourologiya = Cancer Urology 2020;16(4):129–35. (In Russ.). DOI: 10.17650/1726-9776-2020-16-4-129-135

23. https://www.pharmjournal.ru/jour/announcement/view/1527

24. https://prostorpharma.ru/preparaty/rflp-radiya-xlorid-223ra/


Review

For citations:


Perepukhov V.M., Alekseev B.Ya., Nyushko K.M. Modern approaches to treatment of castration-resistant prostate cancer using targeted radionuclide therapy in patients with bone metastases. Cancer Urology. 2024;20(4):132-138. (In Russ.) https://doi.org/10.17650/1726-9776-2024-20-4-132-138

Views: 169


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1726-9776 (Print)
ISSN 1996-1812 (Online)
X