By Daniel Appelbaum, MD
For patients with castrate-resistant prostate cancer with widespread bone metastases, there have been very limited options that both treated the bone pain and prolonged life in a meaningful way.
We’re hoping until now.
Last week, we were the first academic medical center to administer a very recently approved radiopharmaceutical therapy designed to do both.
Radium-223 dichloride (Xofigo®, Bayer Health Care) targets bone lesions with very high-energy alpha particles. These alpha particles travel very short distances within the patient (far less than a millimeter) and hence are less damaging to surrounding structures than conventional radiation therapies.
Administered intravenously, this is sort of the ‘magic bullet’ oncologists look for in a therapy. Side effects are minimal, and the post-treatment survival has been extended from approximately 11 to 14 months, according to recent studies. In our case, we have done the first of six monthly treatments for this patient, although he reported a significant reduction in pain just one day following the first injection.
Some questions surrounding this therapy are: can the dose of radium-223 be safely increased and can it be combined with other therapies for even better outcomes? We’re exploring the idea of clinical trials to try and answer these questions.
Daniel Appelbaum, MD, is both a radiologist and nuclear medicine physician. He has expertise in the full spectrum of nuclear/molecular imaging, specializing in oncologic, neurologic, cardiac, and positron emission tomographic (PET and PET/CT) applications. Dr. Appelbaum and his colleagues offer a full array of both diagnostic and therapeutic nuclear exams and procedures for adults and children at the University of Chicago.