Yeku Oladapo, Slovin Susan F
Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, Genitourinary Oncology Service , 1275 York Avenue, New York, NY 10065 , USA +1 646 422 4470 ;
Expert Opin Drug Metab Toxicol. 2015 May;11(5):843-9. doi: 10.1517/17425255.2015.1021332. Epub 2015 Mar 4.
Prostate cancer metastatic to bone is a cause of significant morbidity and mortality. Bone pain and other skeletal events negatively impact the quality of life in patients who might otherwise be functioning well. As such, there has been intense interest in the development of strategies and pharmaceuticals to address this problem.
The authors reviewed the current literature for articles relevant to metastatic prostate cancer, clinical radiopharmaceuticals, castrate-resistant prostate cancer and development of Radium-223 . The authors have referenced primary literature, clinical trials and relevant review articles that summarize the history, development and current utilization of radiopharmaceuticals for management of bone metastases from prostate cancer.
Radium-223 is the first radiopharmaceutical with an overall survival benefit approved for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastasis and no known visceral metastatic disease. The additional benefit of clinically significant improved overall survival should lead to exploration of whether this agent can be used earlier in the treatment algorithm or combined with chemotherapy or androgen deprivation therapy. An individualized approach needs to be tailored to each patient based on their overall symptoms, disease burden, hematologic profile and goals of care.
前列腺癌骨转移是导致严重发病和死亡的原因。骨痛和其他骨骼事件会对原本可能功能良好的患者的生活质量产生负面影响。因此，人们对开发解决这一问题的策略和药物有着浓厚的兴趣。
作者回顾了当前文献中与转移性前列腺癌、临床放射性药物、去势抵抗性前列腺癌以及镭 - 223 的研发相关的文章。作者引用了原始文献、临床试验和相关综述文章，这些文献总结了放射性药物用于治疗前列腺癌骨转移的历史、发展和当前应用情况。
镭 - 223 是首个被批准用于治疗去势抵抗性前列腺癌、有症状骨转移且无已知内脏转移疾病患者并具有总生存获益的放射性药物。临床上显著改善总生存的额外益处应促使人们探索该药物是否可在治疗方案中更早使用，或与化疗或雄激素剥夺疗法联合使用。需要根据每位患者的总体症状、疾病负担、血液学特征和护理目标制定个性化的治疗方案。
