Using Radium-223 to Treat Metastatic Prostate Cancer

The following article was written by Miguel Hernandez Pampaloni, MD, PhD, an Assistant Professor in Residence and Chief of Nuclear Medicine in the Department of Radiology and Biomedical Imaging at UCSF.

The Nuclear Medicine Clinic at UCSF is pleased to be providing a new treatment option for men with advanced prostate cancer. Xofigo (Radium-223 dichloride) was approved by the Food and Drug Administration in May 2013 and is intended to be used in the treatment of patients whose prostate cancer has spread (metastasized) to their bones and who have already received treatment to lower testosterone.

Evidence from a recent study conducted in 900 prostate cancer patients, the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA), indicates that treatment with Radium-223 dichloride significantly prolonged overall survival, improves  skeletal pain and delays the first symptomatic skeletal event.

According to the National Cancer Institute, the most common site of metastasis in prostate cancer is the bone. When metastatic prostate cancer spreads to the bones, the effects can be devastating. Severe bone disease that results from the spread of prostate cancer may cause uncontrolled and unrelenting pain for patients. Many suffer pathologic fractures, increased disability and death, at the most advanced stages. Radium-223 dichloride can help.

What is Radium-223 dichloride? It’s a radiopharmaceutical that delivers radiation directly to bone tissue by binding with minerals in the bone, sparing normal surrounding tissues from significant damage.  A course of treatment is only 6 intravenous injections that are 4 weeks apart, which also reduces the frequency and severity of side effects produced by chemotherapy. In the clinical trials with Radium-223 dichloride it was also found that the most common side effects were mild and self-limiting episodes of nausea, diarrhea and vomiting. Due to the properties of radium-223 dichloride it can be safely administered in an out patient setting with no radiation exposure risk to the public.

For more information about the Radium-223 dichloride or other nuclear medicine services offered at the UCSF Department of Radiology and Biomedical Imaging, please contact us here.

For more information on the ALSYMPCA study, please see here.