Survival benefit of early radium-223 dichloride therapy in castration-resistant prostate cancer patients with osteoblastic bone metastases

Le résumé fourni par la source

The aim of the retrospective cohort study was to evaluate the overall survival of patients with castration-resistant prostate cancer and osteoblastic bone metastases without visceral metastases treated with 223Radium dichloride (223Ra).The cohort included 55 patients aged 48 to 86, with a median age of 71.Overall survival from the first administered cycle (from 7/2015 to 7/2019) was evaluated in 10/2024.The median overall survival was, despite a smaller cohort, 16.27 months (CI: 11.87-20.98months), comparable to other large real-world studies.Asymptomatic or mildly symptomatic patients with good performance status (ECOG 0-1) at the start of therapy had a significantly higher median survival than more symptomatic patients with ECOG 2 and 3 (22.42 vs. 8.06 and 3.28 months).The number of completed cycles of 223Ra was inversely proportional to the patients' performance status (ECOG) -Kendall's Tau-c = -0.625;p < 0.0001.Previous treatment with chemotherapy (41.2 % of patients) was associated with significantly worse survival on multivariable analysis.A decrease of serum PSA by more than 50% (12.7% of patients) was significantly associated with longer survival (31 months; p = 0.0043).Severe (Grade 3) anemia, leukopenia, and thrombocytopenia occurred in only 9.1%, 3.6%, and 3.6% of patients.Earlier indication of 223Ra dichloride therapy in asymptomatic or mildly symptomatic patients with good performance status (ECOG 0-1) and without prior chemotherapy improved survival in our cohort.The decrease in serum PSA during treatment was a good prognostic factor associated with longer survival.Key words: radium-223 dichloride; metastatic castration-resistant prostate cancer; osteoblastic bone metastases Bone metastases affect approximately 90% of patients with metastatic prostate cancer [1] and significantly impact both the quality of life and overall survival [2].In Slovakia, since 2015, patients with castration-resistant prostate cancer (CRPC) exhibiting osteoblastic bone metastases confirmed via bone scintigraphy, and without visceral metastases, are eligible for radionuclide therapy using radioactive radium-223 ( 223 Ra dichloride).Radium-223 is the first clinically approved

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.