Orazio Caffo1, Viviana Frantellizzi2, Fabio Monari3, Luca Galli4, Renato Patrizio Costa5, Carmine Pinto6, Marcello Tucci7, Sergio Baldari8, Gaetano Facchini9, Roberto Bortolus10, Filippo Alongi11,12, Pierpaolo Alongi13, Davide Donner14, Stefano Fanti15, Andrea Sbrana4, Alessandra Morabito5, Cristina Masini6, Clizia Zichi16, Salvatore Pignata8, Eugenio Borsatti17, Matteo Salgarello18, Massimiliano Spada19, Ugo De Giorgi20, Giovanni Lo Re21, Enrico Cortesi2, Giuseppe De Vincentis2. 1. Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy. 2. Department of Radiological, Oncological and Anatomo-Pathological Sciences, La Sapienza University, Rome, Italy. 3. Department of Radiotherapy, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 4. Department of Medical Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. 5. Department of Nuclear Medicine, Policlinico Universitario, Palermo, Italy. 6. Medical Oncology Unit, Clinical Cancer Centre, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 7. Department of Medical Oncology, Cardinal Massaia Hospital, Asti, Italy. 8. Department of Biomedical and Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy. 9. Department of Medical Oncology, S.M. delle Grazie Hospital, Pozzuoli, Italy. 10. Department of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy. 11. Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy. 12. University of Brescia, Brescia, Italy. 13. Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Italy. 14. Department of Nuclear Medicine, Santa Chiara Hospital, Trento, Italy. 15. Department of Nuclear Medicine Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. 16. Department of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy. 17. Department of Nuclear Medicine Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy. 18. Department of Nuclear Medicine Oncology IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy. 19. Department of Medical Oncology, Fondazione Istituto G. Giglio, Cefalù, Italy. 20. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy. 21. Department of Medical Oncology, Santa Maria degli Angeli Hospital, Pordenone, Italy.
Abstract
Background: The retrospective studies that have so far described the outcomes of the sequential use of life-prolonging agents (LPAs) did not include metastatic castration-resistant prostate cancer (mCRPC) patients who received radium-223 (223Ra) as part of their treatment. Consequently, it is not known whether including 223Ra in the therapeutic sequence has an impact on cumulative survival. The aim of this study was to evaluate this impact by comparing the cumulative overall survival (OS) in two series of mCRPC patients sequentially treated with two or three LPAs after first-line docetaxel (DOC), including 223Ra and not. Materials and Methods: The authors retrospectively reviewed the records of mCRPC patients with bone involvement alone who received two or three LPAs (including 223Ra) after first-line DOC. The control group was a contemporary series of mCRPC patients with bone involvement alone treated with sequences of two or three LPAs other than 223Ra after first-line DOC. Results: Median cumulative OS was 40.6 months in the 223Ra group of 78 patients and 36.2 months in the non-223Ra group of 186 patients (p = 0.08). OS outcomes were significantly influenced by the number of treatment lines, and baseline Eastern Cooperative Oncology Group performance status (PS) and prostate-specific antigen levels. Conclusions: To the best of the authors' knowledge, this is the first study designed to evaluate the impact of introducing 223Ra in the treatment sequences for mCRPC patients, and the results show that its use does not negatively affect cumulative OS.
Background: The retrospective studies that have so far described the outcomes of the sequential use of life-prolonging agents (LPAs) did not include metastatic castration-resistant prostate cancer (mCRPC) patients who received radium-223 (223Ra) as part of their treatment. Consequently, it is not known whether including 223Ra in the therapeutic sequence has an impact on cumulative survival. The aim of this study was to evaluate this impact by comparing the cumulative overall survival (OS) in two series of mCRPC patients sequentially treated with two or three LPAs after first-line docetaxel (DOC), including 223Ra and not. Materials and Methods: The authors retrospectively reviewed the records of mCRPC patients with bone involvement alone who received two or three LPAs (including 223Ra) after first-line DOC. The control group was a contemporary series of mCRPC patients with bone involvement alone treated with sequences of two or three LPAs other than 223Ra after first-line DOC. Results: Median cumulative OS was 40.6 months in the 223Ra group of 78 patients and 36.2 months in the non-223Ra group of 186 patients (p = 0.08). OS outcomes were significantly influenced by the number of treatment lines, and baseline Eastern Cooperative Oncology Group performance status (PS) and prostate-specific antigen levels. Conclusions: To the best of the authors' knowledge, this is the first study designed to evaluate the impact of introducing 223Ra in the treatment sequences for mCRPC patients, and the results show that its use does not negatively affect cumulative OS.