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Evolving treatment approaches for the management of metastatic castration-resistant prostate cancer – role of radium-223

Authors Mukherji D, El Dika I, Temraz S, Haidar M, Shamseddine A

Received 13 March 2014

Accepted for publication 23 April 2014

Published 23 May 2014 Volume 2014:10 Pages 373—380

DOI https://doi.org/10.2147/TCRM.S45667

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Deborah Mukherji,1 Imane El Dika,1 Sally Temraz,1 Mohammed Haidar,2 Ali Shamseddine1

1Department of Hematology/Oncology, 2Department of Nuclear Medicine, American University of Beirut Medical Center, Beirut, Lebanon

Abstract: Radium-223 is a first-in-class alpha particle-emitting radiopharmaceutical approved for the treatment of bone metastatic castration-resistant prostate cancer. Radium-223 is administered intravenously with no requirement for complex shielding and specifically targets areas of bone metastasis. In a randomized placebo-controlled Phase III study, treatment with radium-223 was shown to improve overall survival, time to skeletal-related events, and health-related quality of life. Apart from radium-223, the cytotoxic chemotherapy agents docetaxel and cabazitaxel, androgen biosynthesis inhibitor abiraterone acetate, novel anti-androgen enzalutamide, and immunotherapy sipuleucel-T have also been shown to improve survival of men with advanced prostate cancer in Phase III trials. This review will outline current treatment approaches for advanced prostate cancer with a focus on the role of radium-223 in changing treatment paradigms.

Keywords: Alpharadin, alpha-emitting radionuclide, bone metastasis

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