Opinion

Video

The Evolving Role of Radium-223 in mCRPC and the Impact of Combination Therapies

Key Takeaways

  • The PEACE III study explores combining radium-223 with androgen receptor-targeted therapies to improve PSA control in prostate cancer treatment.
  • Radium-223's poor clinical uptake is due to its inability to control PSA alone, necessitating combination with androgen receptor inhibitors.
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Panelists discuss how combining radium-223 with androgen receptor–targeted therapy like enzalutamide addresses historical challenges in treating metastatic castration-resistant prostate cancer, including poor radium-223 uptake, prostate-specific androgen–level control issues, and the need for multimodal treatment approaches.

Video Content above is prompted by the following:

  • What are the challenges, historically, that the PEACE III study addresses?
  • Discuss reasons for the relatively poor uptake of radium-223 (Xofigo) in the clinic.
  • Radium alone doesn’t control prostate-specific androgen (PSA), nor does docetaxel. PSA control is addressed by androgen receptor inhibitor (ARI).
  • Layered radium-223 and enzalutamide plus ARI will control PSA, so radium-223 can be administered without being questioned or second-guessed.
  • Similar to the ARASENS trial, maintain relationship and management and share care with med oncology for docetaxel.
  • Discuss the rationale for combining radium-223 with androgen receptor–targeted therapy (enzalutamide). (Sartor et al [2018]; Shore et al [2020])
  • Allows for 2 distinct mechanisms of action.

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