Orazio Caffo1, Viviana Frantellizzi2, Marcello Tucci3, Luca Galli4, Fabio Monari5, Sergio Baldari6, Cristina Masini7, Roberto Bortolus8, Gaetano Facchini9, Pierpaolo Alongi10, Stefania Agostini11, Clizia Zichi3, Elisa Biasco4, Stefano Fanti12, Salvatore Pignata6, Angelina Filice13, Eugenio Borsatti14, Sabrina Rossetti9, Massimiliano Spada15, Enrico Cortesi2, Giuseppe De Vincentis2. 1. Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, 38100, Trento, Italy. orazio.caffo@apss.tn.it. 2. Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy. 3. Department of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy. 4. Department of Medical Oncology, AOU Pisana, Pisa, Italy. 5. Department of Radiotherapy, S. Orsola Malpighi Hospital, Bologna, Italy. 6. Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy. 7. Department of Medical Oncology, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. 8. Department of Radiation Oncology, NCI-IRCCS of Aviano, Aviano, Italy. 9. Departmental Unit of Experimental Uro-Andrological Clinical Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy. 10. Nuclear Medicine Unit, Fondazione Istituto G.Giglio, Cefalù, Italy. 11. Department of Nuclear Medicine, Santa Chiara Hospital, Trento, Italy. 12. Department of Nuclear Medicine, S. Orsola Malpighi Hospital, Bologna, Italy. 13. Department of Nuclear Medicine, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy. 14. Department of Nuclear Medicine, NCI of Aviano, Aviano, Italy. 15. Department of Medical Oncology, Fondazione Istituto G.Giglio, Cefalù, Italy.
Abstract
PURPOSE: To evaluate the fracture risk and survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) who received sequentially abiraterone acetate (AA) and radium 223 [223Ra]RaCl2 in the daily clinical practice. MATERIALS: We retrospectively reviewed the records of mCRPC patients who received [223Ra]RaCl2 immediately after progressing during an AA treatment line in everyday clinical practice. RESULTS: We reviewed data of a consecutive series of 94 mCRPC patients. Most of the patients (85.1%) received [223Ra]RaCl2 as second- or third-line treatment. [223Ra]RaCl2 treatment was well-tolerated; there were only four cases of grade 3 anaemia, two cases of grade 3 leukopenia and one case of grade 3 neutropenia. The overall fracture rate is 2.1%; one fracture was recorded during the course of [223Ra]RaCl2 treatment, and one was recorded 1 month after its end. The fractures both occurred at metastatic sites. Median OS from [223Ra]RaCl2 start was more than 14 months regardless of the treatment line when [223Ra]RaCl2 was administered. CONCLUSION: The findings of this study show that the treatment with [223Ra]RaCl2 immediately after AA was active and safe with a very low risk of a fracture. Thus, the present observational report makes a valuable contribution to the current debate concerning the risks and benefits of including [223Ra]RaCl2 in the therapeutic algorithm.
PURPOSE: To evaluate the fracture risk and survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) who received sequentially abiraterone acetate (AA) and radium 223 [223Ra]RaCl2 in the daily clinical practice. MATERIALS: We retrospectively reviewed the records of mCRPC patients who received [223Ra]RaCl2 immediately after progressing during an AA treatment line in everyday clinical practice. RESULTS: We reviewed data of a consecutive series of 94 mCRPC patients. Most of the patients (85.1%) received [223Ra]RaCl2 as second- or third-line treatment. [223Ra]RaCl2 treatment was well-tolerated; there were only four cases of grade 3 anaemia, two cases of grade 3 leukopenia and one case of grade 3 neutropenia. The overall fracture rate is 2.1%; one fracture was recorded during the course of [223Ra]RaCl2 treatment, and one was recorded 1 month after its end. The fractures both occurred at metastatic sites. Median OS from [223Ra]RaCl2 start was more than 14 months regardless of the treatment line when [223Ra]RaCl2 was administered. CONCLUSION: The findings of this study show that the treatment with [223Ra]RaCl2 immediately after AA was active and safe with a very low risk of a fracture. Thus, the present observational report makes a valuable contribution to the current debate concerning the risks and benefits of including [223Ra]RaCl2 in the therapeutic algorithm.
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