Cargando…

Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy

Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer...

Descripción completa

Detalles Bibliográficos
Autores principales: Wenter, Vera, Herlemann, Annika, Fendler, Wolfgang P., Ilhan, Harun, Tirichter, Natalia, Bartenstein, Peter, Stief, Christian G., la Fougère, Christian, Albert, Nathalie L., Rominger, Axel, Gratzke, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546468/
https://www.ncbi.nlm.nih.gov/pubmed/28484088
http://dx.doi.org/10.18632/oncotarget.17311
_version_ 1783255553815871488
author Wenter, Vera
Herlemann, Annika
Fendler, Wolfgang P.
Ilhan, Harun
Tirichter, Natalia
Bartenstein, Peter
Stief, Christian G.
la Fougère, Christian
Albert, Nathalie L.
Rominger, Axel
Gratzke, Christian
author_facet Wenter, Vera
Herlemann, Annika
Fendler, Wolfgang P.
Ilhan, Harun
Tirichter, Natalia
Bartenstein, Peter
Stief, Christian G.
la Fougère, Christian
Albert, Nathalie L.
Rominger, Axel
Gratzke, Christian
author_sort Wenter, Vera
collection PubMed
description Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Ten patients with primary bone metastases received Ra-223 following radical prostatectomy (RP). Changes in alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were recorded, while pain intensity was evaluated using the self-reporting Brief Pain Inventory (BPI) questionnaire. Bone scintigraphy (BS) was performed to assess treatment response. Seven patients completed six cycles of Ra-223. Discontinuation was due to leuko- and lymphopenia, progressive lymph node metastasis or newly diagnosed liver metastasis. Treatment-related adverse events occurred in three patients and included leuko- and lymphopenia, fatigue, abdominal discomfort and nausea. Overall, a median decrease of 28% in ALP and a median decrease of 83% in PSA were noted at follow-up. However, PSA progressed in five patients at follow-up. Improvement of pain was observed in all patients (median decrease of 36% after 3 cycles and of 40% at the end of therapy). On BS, three patients showed remission, four had stable disease, and one showed progressive disease at follow-up. Our results suggest that Ra-223 for primary bone metastases in patients with mHSPC after RP is feasible and alleviates pain. ALP, rather than PSA, may be a good marker for assessing treatment response. Ra-223 could therefore be taken into consideration as part of a multimodal approach for carefully selected patients with advanced prostate cancer.
format Online
Article
Text
id pubmed-5546468
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Impact Journals LLC
record_format MEDLINE/PubMed
spelling pubmed-55464682017-08-23 Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy Wenter, Vera Herlemann, Annika Fendler, Wolfgang P. Ilhan, Harun Tirichter, Natalia Bartenstein, Peter Stief, Christian G. la Fougère, Christian Albert, Nathalie L. Rominger, Axel Gratzke, Christian Oncotarget Research Paper Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Ten patients with primary bone metastases received Ra-223 following radical prostatectomy (RP). Changes in alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were recorded, while pain intensity was evaluated using the self-reporting Brief Pain Inventory (BPI) questionnaire. Bone scintigraphy (BS) was performed to assess treatment response. Seven patients completed six cycles of Ra-223. Discontinuation was due to leuko- and lymphopenia, progressive lymph node metastasis or newly diagnosed liver metastasis. Treatment-related adverse events occurred in three patients and included leuko- and lymphopenia, fatigue, abdominal discomfort and nausea. Overall, a median decrease of 28% in ALP and a median decrease of 83% in PSA were noted at follow-up. However, PSA progressed in five patients at follow-up. Improvement of pain was observed in all patients (median decrease of 36% after 3 cycles and of 40% at the end of therapy). On BS, three patients showed remission, four had stable disease, and one showed progressive disease at follow-up. Our results suggest that Ra-223 for primary bone metastases in patients with mHSPC after RP is feasible and alleviates pain. ALP, rather than PSA, may be a good marker for assessing treatment response. Ra-223 could therefore be taken into consideration as part of a multimodal approach for carefully selected patients with advanced prostate cancer. Impact Journals LLC 2017-04-21 /pmc/articles/PMC5546468/ /pubmed/28484088 http://dx.doi.org/10.18632/oncotarget.17311 Text en Copyright: © 2017 Wenter et al. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (http://creativecommons.org/licenses/by/3.0/) (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Paper
Wenter, Vera
Herlemann, Annika
Fendler, Wolfgang P.
Ilhan, Harun
Tirichter, Natalia
Bartenstein, Peter
Stief, Christian G.
la Fougère, Christian
Albert, Nathalie L.
Rominger, Axel
Gratzke, Christian
Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title_full Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title_fullStr Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title_full_unstemmed Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title_short Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
title_sort radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546468/
https://www.ncbi.nlm.nih.gov/pubmed/28484088
http://dx.doi.org/10.18632/oncotarget.17311
work_keys_str_mv AT wentervera radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT herlemannannika radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT fendlerwolfgangp radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT ilhanharun radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT tirichternatalia radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT bartensteinpeter radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT stiefchristiang radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT lafougerechristian radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT albertnathaliel radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT romingeraxel radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy
AT gratzkechristian radium223forprimarybonemetastasesinpatientswithhormonesensitiveprostatecancerafterradicalprostatectomy