Welcome, this website is intended for international healthcare professionals with an interest in the treatment of Advanced Prostate Cancer. By clicking the link below you are declaring and confirming that you are a healthcare professional

You are here

Chemotherapy following radium-223 dichloride treatment in ALSYMPCA

Sartor O, Hoskin P, Coleman RE, Nilsson S, Vogelzang NJ, Petrenciuc O, et al.

Abstract

BACKGROUND:

Radium-223 prolongs overall survival in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases, regardless of prior docetaxel. Whether or not chemotherapy can be safely administered following radium-223 treatment is of clinical importance. An exploratory analysis of prospectively collected data, from the ALSYMPCA (ALpharadin in SYMptomatic Prostate CAncer) patient subgroup who received chemotherapy after radium-223 or placebo treatment, was conducted to evaluate the safety and efficacy of chemotherapy following radium-223.

METHODS:

In ALSYMPCA, CRPC patients with symptomatic bone metastases and no visceral metastases were randomized 2:1 to receive six injections of radium-223 (50 kBq/kg IV) or placebo plus best standard of care, stratified by prior docetaxel, baseline alkaline phosphatase, and current bisphosphonate use. In this exploratory analysis, chemotherapy agents administered following study treatment were identified; timing and duration were calculated. Hematologic safety was reviewed, and overall survival analyzed.

RESULTS:

Overall, 142 radium-223 and 64 placebo patients received subsequent chemotherapy; most common were docetaxel (70% radium-223, 72% placebo) and mitoxantrone (16% radium-223, 20% placebo). The majority of patients (61% radium-223, 58% placebo) had received prior docetaxel. Radium-223 patients started subsequent chemotherapy later than placebo patients; chemotherapy duration was similar between groups. In radium-223 and placebo patients receiving subsequent chemotherapy, median hematologic values (hemoglobin, neutrophils, and platelets) remained nearly constant up to 18 months following start of chemotherapy, regardless of prior docetaxel treatment. A low percentage of patients in both groups had grades 3-4 hematologic values (<10%). Platelet count decline, from last measurement before chemotherapy, was numerically greater in radium-223 versus placebo patients. Median overall survivals from start of chemotherapy were 16.0 and 15.8 months following radium-223 and placebo, respectively.

CONCLUSIONS:

Chemotherapy following radium-223, regardless of prior docetaxel, is feasible and appears to be well tolerated in patients with CRPC and symptomatic bone metastases. Prostate 76:905-916, 2016. © 2016 The Authors. The Prostate published by Wiley Periodicals, Inc.

© 2016 The Authors. The Prostate published by Wiley Periodicals, Inc.

KEYWORDS:

alpha emitter; bone; chemotherapy; prostate; radium-223; safety

©PubMed Central

Share

E-Alert

Register to be notified when new content is published. Only your name, country and email address needed.

Subscribe »

Latest webcast

ESMO 2016 Symposium webcast

Individualizing treatment in
metastatic prostate cancer: there
is no “one-size-fits-all” approach

EAU 2016 Scientific Programme and Sessions

View the Scientific Programme and Sessions of the 2016 EAU Annual Congress, Munich, Germany.

The editorial independence of the resource centre is mandatory and recognized by the EAU and Elsevier.
The journal articles, videos and statements published on the resource centre have been selected independently and without influence from Elsevier, European Urology Editors or the sponsor and do not necessarily reflect their opinions or views

Search this site

Search form