Opinion|Videos|October 21, 2024
The Evolving Role of Radium-223 in mCRPC and the Impact of Combination Therapies
Author(s)Pedro Barata, MD, MSc, FACP
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.
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.
Advertisement
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.
Advertisement
Related to this article
The designation was supported by findings from the phase 2 Co-PSMA trial, the phase 1/2 COBRA trial, and real-world evidence.
American Cancer Society updates prostate cancer screening guidelines, recommends regular PSA testing
The updated guidance recommends routine PSA-based screening every 2 years for average-risk men aged 50 to 69 years and annual screening beginning at age 45 for Black men or men with a strong family history of prostate cancer.
Pasritamig is being evaluated with or without JNJ-9401 in the ongoing phase 3 KLK2-comPAS trial.
These FAQs outline key recommendations from ASTRO's updated guideline on shorter-course radiation therapy for localized prostate cancer.
Updated CAPItello-281 data support capivasertib plus abiraterone in PTEN-deficient mHSPC, according to Daniel J. George, MD.
Benjamin Garmezy, MD, discusses personalizing mHSPC treatment intensification based on disease burden, molecular biomarkers, and patient-specific factors.
Biomarkers including HRR mutations, PTEN loss, and PSMA expression can guide triplet selection in mHSPC, according to Benjamin Garmezy, MD.
Alicia Morgans, MD, discusses ARACOG findings on cognitive outcomes with darolutamide vs enzalutamide and the influence of genetic dementia risk.
Advertisement
Advertisement
Trending on Urology Times
1
American Cancer Society updates prostate cancer screening guidelines, recommends regular PSA testing
2
FDA grants breakthrough therapy designation to 64Cu-SAR-bisPSMA for recurrent prostate cancer imaging
3
BCG-naïve NMIBC: Optimizing initial treatment selection
4
FDA grants De Novo authorization to Virtuoso Robotic System for bladder tumor resection
5