Malou Cp Kuppen1, Hans M Westgeest2, Maarten J van der Doelen3, Alphonsus Jm van den Eertwegh4, Jules Llm Coenen5, Katja Kh Aben6,7, Alphons Cm van den Bergh8, Andries M Bergman9, Joan van den Bosch10, Filiz Celik11, Mathijs P Hendriks12, Jules Lavalaye13, Saskia van der Meer14, Marco B Polee15, Diederik M Somford16, Inge M van Oort17, Carin A Uyl-de Groot1, Winald R Gerritsen3. 1. Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. 2. Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands. 3. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands. 5. Department of Oncology, Isala, Zwolle, The Netherlands. 6. Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands. 7. Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands. 8. Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands. 9. Division of Internal Medicine (MOD) & Oncogenomics, the Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 10. Department of Internal Medicine, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands. 11. Department of Nuclear Medicine, Deventer Hospital, Deventer, The Netherlands. 12. Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands. 13. Department of Nuclear Medicine, St Antonius Hospital, Nieuwegein, The Netherlands. 14. Department of Urology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. 15. Department of Internal Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands. 16. Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. 17. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
Aim: Timing of radium-223 (Ra-223) in metastatic castration-resistant prostate cancer (mCRPC) remains challenging due to alternative options and short window of opportunity. Methods: Ra-223 treated patients in the CAPRI-registry were included. Outcomes were evaluated based on treatment line of Ra-223. Results: Out of 285 patients, 49% received Ra-223 in line ≥3. 51% completed six Ra-223 injections and 34% had a symptomatic skeletal event after first Ra-223 without differences between subgroups. After correction of known prognostic factors Ra-223 in line ≥3 (HR: 3.267; 95% CI: 1.689-6.317; p < 0.01) remained associated with worse OS. Conclusion: In the Netherlands, Ra-223 was mainly started as second or third mCRPC-treatment in 2014-2018. Later timing of Ra-223 did affect OS, but not treatment completion and occurrence of symptomatic skeletal events.
Aim: Timing of radium-223 (Ra-223) in metastatic castration-resistant prostate cancer (mCRPC) remains challenging due to alternative options and short window of opportunity. Methods:Ra-223 treated patients in the CAPRI-registry were included. Outcomes were evaluated based on treatment line of Ra-223. Results: Out of 285 patients, 49% received Ra-223 in line ≥3. 51% completed six Ra-223 injections and 34% had a symptomatic skeletal event after first Ra-223 without differences between subgroups. After correction of known prognostic factors Ra-223 in line ≥3 (HR: 3.267; 95% CI: 1.689-6.317; p < 0.01) remained associated with worse OS. Conclusion: In the Netherlands, Ra-223 was mainly started as second or third mCRPC-treatment in 2014-2018. Later timing of Ra-223 did affect OS, but not treatment completion and occurrence of symptomatic skeletal events.
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