Treatment outcomes with radium-223 in patients with metastatic castration-resistant prostate cancer with bone metastasis in real-world practice: a multiinstitutional study

IF 2.6 2区医学 Q2 UROLOGY & NEPHROLOGY

Prostate International Pub Date : 2025-09-01 DOI:10.1016/j.prnil.2025.03.004

Hiroyuki Kitano , Kunihiro Hashimoto , Yasuhisa Hasegawa , Akira Fujita , Shunsuke Shinmei , Fumiaki Kirishima , Satoshi Shirane , Akihiro Asami , Miki Naito , Yuki Kohada , Kohei Kobatake , Yohei Sekino , Masao Kato , Yuichi Kadonishi , Hideki Mochizuki , Mitsuru Kajiwara , Nobuyuki Hinata

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引用次数: 0

Abstract

Background

Radium-223 (Ra-223) treatment is used to extend the overall survival (OS) of patients with metastatic castration-resistant prostate cancer (mCRPC) with bone metastases. However, the optimal timing for its administration remains ambiguous. Hence, this study aimed to determine the optimal timing for Ra-223 administration.

Materials and methods

We retrospectively included Japanese men with mCRPC with bone metastases who were treated with Ra-223. The primary endpoint was OS from Ra-223 treatment. Secondary endpoints included the maximum reduction in alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and prostate-specific antigen (PSA) levels and the incidence of adverse events following Ra-223 treatment. The exploratory endpoint was the association between clinical parameters and OS.

Results

Overall, 100 men with mCRPC with bone metastasis treated with Ra-223 wereenrolled. The median OS from the Ra-223 treatment was 38.6 months. Post Ra-223 treatment, ALP, LDH, and PSA levels decreased in 78.6%, 56.1%, and 44.9% of patients, respectively. Grade ≥3 anemia occurred in three (4.1%) patients. The median OS of patients with ≥10 months from diagnosis to developing mCRPC (52.4 months, P < 0.014), a PSA doubling time ≥3 months (52.4 months, P = 0.035), prior docetaxel (DOC) treatment (108.2 months, P = 0.002), five or less numbers of bone metastasis (97.9 months, P = 0.006), five or more cycles of Ra-223 treatment (46.1 months, P = 0.045), hemoglobin measuring ≥13.1 g/dl (52.4 months, P = 0.003), ALP measuring ≤260 (54.8 months, P = 0.003), or LDH measuring ≤220 (46.1 months, P = 0.002) was significantly longer than that of those who had <10 months from diagnosis to developing mCRPC, a PSA doubling time <3 months, absence of prior DOC treatment, more than five bone metastasis, less than four cycles of Ra-223 treatment, hemoglobin measuring <13.1 g/dl, ALP measuring >260, or LDH measuring >220. Multivariate analysis showed that prior DOC administration prolonged the OS.

Conclusions

Ra-223 treatment is safe and effective for mCRPC.

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在现实世界的实践中，镭-223治疗转移性去势抵抗性前列腺癌伴骨转移患者的疗效：一项多机构研究

背景：镭-223 （Ra-223）治疗用于延长伴有骨转移的转移性去势抵抗性前列腺癌（mCRPC）患者的总生存期（OS）。然而，其执政的最佳时机仍然模糊不清。因此，本研究旨在确定Ra-223给药的最佳时机。材料和方法我们回顾性纳入了接受Ra-223治疗的伴有骨转移的日本男性mCRPC患者。主要终点是Ra-223治疗的OS。次要终点包括碱性磷酸酶（ALP）、乳酸脱氢酶（LDH）和前列腺特异性抗原（PSA）水平的最大降低以及Ra-223治疗后不良事件的发生率。探索性终点是临床参数与OS之间的关系。结果共纳入100例接受Ra-223治疗的mCRPC骨转移患者。Ra-223治疗的中位OS为38.6个月。接受Ra-223治疗后，78.6%、56.1%和44.9%的患者ALP、LDH和PSA水平分别下降。3例（4.1%）患者发生≥3级贫血。≥10个月患者的平均操作系统诊断发展mCRPC(52.4个月,P & lt; 0.014), PSA倍增时间≥3个月(52.4个月,P = 0.035),之前多西他赛(DOC)治疗(108.2个月,P = 0.002), 5个或更少数量的骨转移(97.9个月,P = 0.006), 5个或5个以上的周期治疗ra - 223(46.1个月,P = 0.045),血红蛋白测量≥13.1 g / dl(52.4个月,P = 0.003),高山测量≤260(54.8个月,P = 0.003),或LDH测量≤220(46.1个月,P = 0.002)明显长于从诊断到发展为mCRPC的时间为10个月、PSA翻倍时间为3个月、未接受DOC治疗、骨转移超过5次、Ra-223治疗少于4个周期、血红蛋白为13.1 g/dl、ALP为260或LDH为220的患者。多因素分析显示，先前服用DOC延长了OS。结论ra -223治疗mCRPC安全有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate International Medicine-Urology

CiteScore

4.40

自引率

26.70%

发文量

审稿时长

35 days

期刊介绍： Prostate International (Prostate Int, PI), the official English-language journal of Asian Pacific Prostate Society (APPS), is an international peer-reviewed academic journal dedicated to basic and clinical studies on prostate cancer, benign prostatic hyperplasia, prostatitis, and ...