Prostate Cancer Coverage from Every Angle

Does Radium-223 Improve Survival in Older Men With Metastatic Castration-Resistant Prostate Cancer?

By: Melissa E. Fryman, MS
Posted: Monday, July 13, 2020

Radium-223 seems to be a good option for patients with castration-resistant prostate cancer and bone metastasis, according to Giuseppe De Vincentis, MD, PhD, of the University of Rome, Italy, and colleagues. The researchers found that, particularly for elderly patients and for those who are otherwise not suited for cytotoxic chemotherapy, the calcium mimetic may induce local cytotoxic effects with few hematologic adverse effects. Their findings were published in the journal Aging Clinical and Experimental Research

This retrospective analysis included 430 patients with metastatic castration-resistant prostate cancer treated with radium-223, from six treatment centers in Italy. Of them, 47% were younger than age 75, and 53% were at least 75 years old.

After controlling for clinical covariates at baseline, the researchers found that overall survival rates did not significantly differ between the two age groups. Analysis of the data using univariate and multivariate models showed that although other baseline clinical attributes, such as hemoglobin, PSA, total alkaline phosphatase, and lactate dehydrogenase levels, may significantly affect the rates of overall survival, age did not. The researchers also found the toxicity profile to be manageable and similar between the two age groups.

“The management of individual elderly patients should not be based on age but on their health status,” concluded the authors. “As observed in this study, radium-223 may prolong survival in both younger and older patients at the same baseline condition and is a good option in the metastatic castration-resistant prostate cancer setting compared [with] other agents.”

Disclosure: For full disclosures of the study authors, visit

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