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radium-223
Indications:
- advanced prostate cancer, including
- castration-resistant prostate cancer with bone metastases*
* only if prior treatment with docetaxel [NGC, NICE)
Contraindications:
- no activity with visceral disease (active only in bone)
Adverse effects:
- myelosuppression rates are low
Mechanism of action:
- alpha-emitting, bone-seeking, calcium mimetic
- binds into newly formed bone stroma
- alpha-particle radiation induces double-stranded DNA breaks
- short path of alpha particles appears to spare surrounding bone marrow
Notes:
- first commercially available targeted alpha therapy
Related
targeted alpha therapy
General
radium [Ra]
antineoplastic agent (chemotherapeutic agent)
References
- Parker C et al.
Alpha emitter radium-223 and survival in metastatic prostate
cancer.
N Engl J Med 2013 Jul 18; 369:213
PMID: 23863050
http://www.nejm.org/doi/full/10.1056/NEJMoa1213755
- Vapiwala N and Glatstein E.
Fighting prostate cancer with radium-223 -
Not your madame's isotope.
N Engl J Med 2013 Jul 18; 369:276
PMID: 23863055
http://www.nejm.org/doi/full/10.1056/NEJMe1304041