Radium-223 Plus Abiraterone or Enzalutamide: Real-World Look at Survival in Prostate Cancer
Posted: Monday, August 9, 2021
A combination treatment of the radionuclide radium-223 plus androgen receptor inhibitors abiraterone or enzalutamide appears to provide limited benefit in terms of survival in patients with castration-resistant prostate cancer with bone metastases, according to research presented in PLOS One. Daniel J. Crona, PhD, of the University of North Carolina at Chapel Hill, and colleagues found that either combination treatment resulted in prolonged progression-free survival without increasing the rate of serious adverse events but had no impact on overall survival. However, these findings are based on a small number of patients from a retrospective analysis.
The study included data from 60 patients with metastatic castration-resistant prostate cancer and bone metastases who had received radium-223 treatment between April 1, 2014, and February 19, 2019. Among those enrolled, 41 patients received radium-223 monotherapy, and 19 received radium-223 plus either abiraterone or enzalutamide.
Median progression-free survival was prolonged substantially in the combination treatment group (7.6 vs. 4.9 months). No meaningful difference in median overall survival was noted between the monotherapy and combination therapy arms (12.7 vs. 12.8 months). The time to first symptomatic skeletal-related event (P = .97), symptomatic skeletal-related event-free survival (P = .16), and the overall rate of serious adverse events (P = .45) were observed to be comparable across both arms.
“This study highlights how real-world considerations for treatment of metastatic castration-resistant prostate cancer, including the role of bone-modifying agents and treatment sequencing, can impact patient treatment outcomes when radium-223 is combined with abiraterone or enzalutamide,” concluded the authors.
Disclosure: For full disclosures of the study authors, visit journals.plos.org.