Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer patients sequentially treated with abiraterone acetate and RADIUM-223

Orazio Caffo, Viviana Frantellizzi, Marcello Tucci, Luca Galli, Fabio Monari, Sergio Baldari, Cristina Masini, Roberto Bortolus, Gaetano Facchini, Pierpaolo Alongi, Stefania Agostini, Clizia Zichi, Elisa Biasco, Stefano Fanti, Salvatore Pignata, Angelina Filice, Eugenio Borsatti, Sabrina Rossetti, Massimiliano Spada, Enrico CortesiGiuseppe De Vincentis

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the fracture risk and survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) who received sequentially abiraterone acetate (AA) and radium 223 [223Ra]RaCl2 in the daily clinical practice. Materials: We retrospectively reviewed the records of mCRPC patients who received [223Ra]RaCl2 immediately after progressing during an AA treatment line in everyday clinical practice. Results: We reviewed data of a consecutive series of 94 mCRPC patients. Most of the patients (85.1%) received [223Ra]RaCl2 as second- or third-line treatment. [223Ra]RaCl2 treatment was well-tolerated; there were only four cases of grade 3 anaemia, two cases of grade 3 leukopenia and one case of grade 3 neutropenia. The overall fracture rate is 2.1%; one fracture was recorded during the course of [223Ra]RaCl2 treatment, and one was recorded 1 month after its end. The fractures both occurred at metastatic sites. Median OS from [223Ra]RaCl2 start was more than 14 months regardless of the treatment line when [223Ra]RaCl2 was administered. Conclusion: The findings of this study show that the treatment with [223Ra]RaCl2 immediately after AA was active and safe with a very low risk of a fracture. Thus, the present observational report makes a valuable contribution to the current debate concerning the risks and benefits of including [223Ra]RaCl2 in the therapeutic algorithm.

Original languageEnglish
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • Abiraterone
  • Fracturative risk
  • Radium 223
  • Safety
  • Sequencing

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Caffo, O., Frantellizzi, V., Tucci, M., Galli, L., Monari, F., Baldari, S., Masini, C., Bortolus, R., Facchini, G., Alongi, P., Agostini, S., Zichi, C., Biasco, E., Fanti, S., Pignata, S., Filice, A., Borsatti, E., Rossetti, S., Spada, M., ... De Vincentis, G. (Accepted/In press). Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer patients sequentially treated with abiraterone acetate and RADIUM-223. European Journal of Nuclear Medicine and Molecular Imaging. https://doi.org/10.1007/s00259-020-04796-w