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    Prognostic factors identified in patients taking PCa Tx

    Concomitant therapy with Ra 223 significantly boosts overall survival, early results suggest

    New Orleans—Analyses of overall survival rates among subgroups of men who received radium-223 dichloride (Ra 223; Xofigo) as part of an expanded access program (EAP) suggest factors that may have prognostic significance, including effects of prior and concomitant treatments.

    Read: A new castration-resistant prostate cancer entity?

    Oliver Sartor, MDDr. SartorFurther study is needed, however, to confirm these preliminary findings, according to Oliver Sartor, MD. 

    “Taken together, the EAP data indicate the safety and tolerability of Ra 223 outside of the randomized phase III trial setting. Further, these data raise the hypothesis that combining Ra 223 with newer agents such as denosumab [XGEVA], abiraterone [ZYTIGA], and/or enzalutamide [XTANDI] may be preferable to sequential approaches,” said Dr. Sartor, Laborde Professor of Cancer Research, departments of medicine and urology, Tulane School of Medicine, New Orleans.

    Dr. Sartor was an investigator in ALSYMPCA, the pivotal trial of Ra 223, and treated men in the EAP. The research was presented at the 2015 American Society of Clinical Oncology annual meeting in Chicago.

    The EAP gave men in the United States and other countries the opportunity to receive Ra 223 for treatment of metastatic castration-resistant prostate cancer (mCRPC) prior to regulatory approval of the alpha-emitting radiopharmaceutical. Men were eligible if they had bony metastases without visceral metastases or lymph node metastases >3 cm. As in the pivotal ALSYMPCA trial, men in the U.S. EAP had to have symptoms from their skeletal metastases, whereas asymptomatic men could receive Ra 223 treatment in the international EAP.

    Analyses of data from 184 patients enrolled in the U.S. EAP focused on the effects of prior treatment with abiraterone acetate and enzalutamide and the prognostic significance of number of Ra 223 injections. According to the prescribing information, Ra 223 should be administered as six monthly injections.

    Next: Less pretreatment linked to more injections

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