Seema Dadhania1, Roberto Alonzi1, Suzanne Douglas2, Andrew Gogbashian3, Rob Hughes1, Danoob Dalili3, Nikhil Vasdev4, Jim Adshead4, Tim Lane4, Charlotte Westbury, Nicola Anyamene1, Pete Ostler1, Peter Hoskin1, Anand Sharma5. 1. Department of Oncology, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, U.K. 2. Department of Nuclear Medicine, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, U.K. 3. Department of Radiology, Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, U.K. 4. Department of Urology and Surgery, Lister Hospital, East and North Herts NHS Trust, Stevenage, U.K. 5. Department of Oncology, Mount Vernon Cancer Centre, Mount Vernon Hospital, Northwood, U.K. anand.sharma3@nhs.net.
Abstract
BACKGROUND: Bone is the most common site of metastatic disease in advanced prostate cancer. Radium-223 (223Ra) is a calcium-mimetic alpha-particle emitter, which has been shown to have activity in prostate cancer with clinical benefit in patients with symptomatic bone metastasis. The recommended schedule is six cycles of 223Ra, 5 kBq/kg, at 4-weekly intervals. Although previous studies have assessed clinical outcomes in patients who received six cycles of Ra223, there is very little information about outcomes of patients receiving fewer courses of treatment. PATIENTS AND METHODS: Patients with hormone-refractory metastatic prostate cancer treated from May 2014 to August 2016 were included in this retrospective study. A total of 113 patients were identified with a median age of 76 (range=52-92) years. The median number of cycles administered was 5 (range=1-6) with 54 (48%) completing six cycles of treatment. Eighty-five patients (75%) received 223Ra prior to docetaxel chemotherapy and 28 (25%) received it after receiving docetaxel. RESULTS: Eleven patients developed grade 2/3 thrombocytopenia, and none of these received further 223Ra. Only 25% of patients who had a haemoglobin level of 10 g/dl or below at the start of the treatment were able to complete six courses of 223Ra. Of the patients who completed fewer than six cycles of 223Ra (1-5 cycles), the survival was 121 days, compared to 398 days in men who received six cycles (odds ratio(OR)=4.767, 95% confidence internal(CI)=1.07-21.25; p=0.0005). CONCLUSION: Careful selection of patients is essential to obtain good clinical outcomes from 223Ra therapy. When fewer than six cycles were delivered then a beneficial survival effect was not seen. Copyright
BACKGROUND: Bone is the most common site of metastatic disease in advanced prostate cancer. Radium-223 (223Ra) is a calcium-mimetic alpha-particle emitter, which has been shown to have activity in prostate cancer with clinical benefit in patients with symptomatic bone metastasis. The recommended schedule is six cycles of 223Ra, 5 kBq/kg, at 4-weekly intervals. Although previous studies have assessed clinical outcomes in patients who received six cycles of Ra223, there is very little information about outcomes of patients receiving fewer courses of treatment. PATIENTS AND METHODS: Patients with hormone-refractory metastatic prostate cancer treated from May 2014 to August 2016 were included in this retrospective study. A total of 113 patients were identified with a median age of 76 (range=52-92) years. The median number of cycles administered was 5 (range=1-6) with 54 (48%) completing six cycles of treatment. Eighty-five patients (75%) received 223Ra prior to docetaxel chemotherapy and 28 (25%) received it after receiving docetaxel. RESULTS: Eleven patients developed grade 2/3 thrombocytopenia, and none of these received further 223Ra. Only 25% of patients who had a haemoglobin level of 10 g/dl or below at the start of the treatment were able to complete six courses of 223Ra. Of the patients who completed fewer than six cycles of 223Ra (1-5 cycles), the survival was 121 days, compared to 398 days in men who received six cycles (odds ratio(OR)=4.767, 95% confidence internal(CI)=1.07-21.25; p=0.0005). CONCLUSION: Careful selection of patients is essential to obtain good clinical outcomes from 223Ra therapy. When fewer than six cycles were delivered then a beneficial survival effect was not seen. Copyright
Authors: S Schumann; U Eberlein; C Lapa; J Müller; S Serfling; M Lassmann; H Scherthan Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-04 Impact factor: 9.236
Authors: Matteo Bauckneht; Sara Elena Rebuzzi; Marta Ponzano; Roberto Borea; Alessio Signori; Viviana Frantellizzi; Elisa Lodi Rizzini; Manlio Mascia; Valentina Lavelli; Alberto Miceli; Maria Silvia De Feo; Antonio Rosario Pisani; Susanna Nuvoli; Vincenzo Tripoli; Alessio Giuseppe Morganti; Paolo Mammucci; Salvatore Caponnetto; Guglielmo Mantica; Angelo Domenico Di Nicola; Carlo Villano; Luca Cindolo; Silvia Morbelli; Gianmario Sambuceti; Stefano Fanti; Renato Patrizio Costa; Angela Spanu; Giuseppe Rubini; Fabio Monari; Giuseppe De Vincentis; Giuseppe Fornarini Journal: Cancers (Basel) Date: 2022-03-29 Impact factor: 6.639