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Radium 223 - Treatment Considerations


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Radium-223 Radiographic Response: From the Desk of the Associate Editor URO Today
Commentary by Andrew Armstrong, MD,ScM, FACP, USA

This is a very brief summary of the take away from this study - Follow the link at the bottom of the article for complete details

Radium-223 is best used early, before extensive soft tissue metastases occurs, and before the risk of spinal cord compression increases. (Note: Soft tissue disease is not being treated whilst Radium-223 therapy is being administered, it is not effective against soft tissue tumors.)

 For this reason when being treated with Radium 223 - concurrent use of systemic therapies should be considered in patients with soft tumors/extra-skeletal metastases.

 Ongoing trials of Radium-223 with enzalutamide, abiraterone, sipuleucel-T, atezolizumab, PARP inhibitors, docetaxel, and other combinations should clarify the optimal combination approaches to controlling bone and soft tissue/visceral metastases.

Patients should be followed carefully for pain flare and are likely to need opiate dose titration during therapy. 

 Concurrent care by a palliative care specialist should be strongly considered, given the life expectancy and palliative needs for these patients.  

Written by: Andrew Armstrong, MD,

Dr. Armstrong is Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology and Associate Director of the Duke Cancer Institute Genitourinary Clinical Research Program

Full Text :- Imaging response during therapy with radium-223 for castration-resistant prostate cancer with bone metastases—analysis of an international multicenter database


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Thanks Barree, I asked my MO about Xofigo 2 days ago and he said it's not available to Aussie's. Is that your understanding?

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Hi Paul

As you would have seen on the face page of our site for the past few months, submissions to the PBAC supporting the subsidized supply of  Xofigo-(Radium 223) closed on October 4th 2017. Your Committee and numerous members prepared and submitted arguments to the PBAC as to why Xofigo should be subsidized and made available on the PBS to Australian men with prostate cancer which has metastasized to the bones.


The outcome of this enquiry is expected to be released on or about November 9th 2017. Until then its a case of keeping our fingers crossed and hoping that our submissions to the PBAC have been successful.


When considering treatment for cancer in the bones, don't overlook the possibility of the up coming Lutetium177  trials.


In some cases, Lutetium177 has been shown to be an effective treatment for bone metastases as well as being an effective treatment for soft tissue tumors. 

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Thanks Barree, I must have missed the discussion about Xofigo on this site, but thanks for pointing it out.

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