Winter B M, von Rundstedt F-C, Grimm M-O
Klinik und Poliklinik für Urologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Urologe A. 2017 Nov;56(11):1435-1439. doi: 10.1007/s00120-017-0514-1.
Since November 2013, the alpha emitter radium-223 dichloride (Alpharadin/Xofigo®) has been approved for the treatment of men with castration-resistant prostate cancer (CRPC) with symptomatic bone metastases and no known visceral metastatic disease. In the ASYMPCA clinical trial, radium-223 was shown to improve overall survival and to reduce the time to the first symptomatic skeletal event. The use of radium-223 was associated with a reduction of pain and an improvement of health-related quality of life compared to the placebo arm. The efficacy of radium-223 dichloride was not inhibited by the use of chemotherapy with docetaxel. Studies have demonstrated a longer overall survival (OS) in patients with a combined treatment of abiraterone or enzalutamide; however, until this data is validated in larger clinical trials, the combination of radium-223 and abiraterone/enzalutamide cannot be recommended. Patients who have received concomitant medication with denosumab appeared to have a longer OS compared to patients who did not. A second treatment cycle of radium-223 was not associated with any adverse events when compared to the outcomes reported in the ASLYMPCA trial. Here the median radiographic progression-free survival was 9 months.
自2013年11月起，α粒子发射体二氯化镭-223（Alpharadin/Xofigo®）已被批准用于治疗有症状性骨转移且无已知内脏转移疾病的去势抵抗性前列腺癌（CRPC）男性患者。在ASYMPCA临床试验中，镭-223被证明可改善总生存期，并减少首次出现症状性骨骼事件的时间。与安慰剂组相比，使用镭-223可减轻疼痛并改善健康相关生活质量。二氯化镭-223的疗效未受多西他赛化疗使用的抑制。研究表明，接受阿比特龙或恩杂鲁胺联合治疗的患者总生存期（OS）更长；然而，在该数据在更大规模临床试验中得到验证之前，不能推荐镭-223与阿比特龙/恩杂鲁胺联合使用。与未接受地诺单抗伴随用药的患者相比，接受地诺单抗伴随用药的患者似乎总生存期更长。与ASYMPCA试验报告的结果相比，镭-223的第二个治疗周期未出现任何不良事件。此处影像学无进展生存期的中位数为9个月。
