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Radium Ra 223 Dichloride

This article explores the use of Radium Ra 223 Dichloride, also known as Xofigo, in clinical trials for treating prostate cancer that has spread to the bones. Radium-223 is a radioactive drug that targets bone metastases in patients with advanced prostate cancer. The trials investigate its effectiveness alone and in combination with other treatments, as well as its safety profile and impact on patients’ quality of life.

Table of Contents

What is RADIUM RA 223 DICHLORIDE?

RADIUM RA 223 DICHLORIDE is a medication used to treat certain types of prostate cancer. It’s also known by several other names, including Xofigo, Alpharadin, and BAY 88-8223[1]. This drug is specifically designed to target cancer that has spread to the bones, a condition known as bone metastases[2].

How does it work?

RADIUM RA 223 DICHLORIDE is what’s called a radiopharmaceutical drug. This means it combines a radioactive substance (radium-223) with a pharmaceutical. When injected into the body, it targets areas where cancer has spread to the bones. The radium-223 then releases small amounts of radiation, which can damage and kill cancer cells[8].

Interestingly, this medication works differently from many other cancer treatments. It specifically targets areas of increased bone turnover, which is common in bone metastases. This targeted approach helps to minimize damage to healthy tissues[1].

What conditions does it treat?

RADIUM RA 223 DICHLORIDE is primarily used to treat a specific type of prostate cancer called metastatic castration-resistant prostate cancer (mCRPC) that has spread to the bones. Let’s break down what this means:

  • Metastatic: The cancer has spread from the prostate to other parts of the body, particularly the bones.
  • Castration-resistant: The cancer continues to grow even when the levels of male hormones (like testosterone) are reduced to very low levels.

This medication is typically used when the cancer has spread to the bones but not to other organs (like the liver or lungs)[3][5].

How is it administered?

RADIUM RA 223 DICHLORIDE is given as an intravenous (IV) injection. This means it’s injected directly into a vein. The typical treatment schedule is:

  • One injection every 4 weeks
  • A total of 6 injections over 24 weeks (about 6 months)

The dose is usually calculated based on the patient’s body weight. A common dose is 55 kilobecquerel (kBq) per kilogram of body weight[2][3].

Combination therapy

RADIUM RA 223 DICHLORIDE is sometimes used in combination with other prostate cancer treatments. Some studies have looked at using it together with medications like:

  • Enzalutamide: A hormone therapy that blocks the effects of testosterone[2].
  • Abiraterone acetate: Another hormone therapy that works by stopping the body from producing testosterone[7].
  • Paclitaxel: A chemotherapy drug[4].

However, it’s important to note that some combinations may increase the risk of side effects. Your doctor will carefully consider the best treatment plan for your specific situation[6].

Effectiveness

Studies have shown that RADIUM RA 223 DICHLORIDE can be effective in treating mCRPC with bone metastases. It may help to:

  • Reduce bone pain
  • Slow the progress of the disease
  • Improve overall survival (help patients live longer)

Researchers are still studying how effective this treatment is when used alone or in combination with other therapies[8].

Side effects

Like all medications, RADIUM RA 223 DICHLORIDE can cause side effects. Some of the most common include:

  • Myelosuppression: This is a decrease in bone marrow activity that can lead to lower blood cell counts. It may cause anemia (low red blood cells), neutropenia (low white blood cells), or thrombocytopenia (low platelets)[4].
  • Nausea and vomiting
  • Diarrhea
  • Fatigue

Your healthcare team will monitor you closely for these and other potential side effects during treatment[8].

Ongoing research

Researchers continue to study RADIUM RA 223 DICHLORIDE to better understand its effects and explore new ways to use it. Some areas of ongoing research include:

  • Using it earlier in the course of prostate cancer treatment[3]
  • Combining it with other treatments to potentially improve effectiveness[2][4]
  • Studying its effects on quality of life and pain relief[8]
  • Investigating how genetic factors might influence how well the treatment works[1]

These ongoing studies aim to help doctors use RADIUM RA 223 DICHLORIDE more effectively and improve outcomes for patients with prostate cancer that has spread to the bones.

Aspect Details
Drug Name Radium Ra 223 Dichloride (Xofigo)
Type of Treatment Targeted alpha particle-emitting radiopharmaceutical
Primary Use Treatment of metastatic castration-resistant prostate cancer with bone metastases
Administration Intravenous injection, typically 55 kBq/kg every 4 weeks for up to 6 cycles
Key Clinical Trials Combination with enzalutamide, abiraterone acetate, and as monotherapy
Primary Outcomes Studied Overall survival, time to first symptomatic skeletal event, quality of life improvements, pain reduction
Secondary Outcomes PSA and ALP levels, radiographic progression-free survival, safety profile
Patient Population Men with mCRPC and bone metastases, both pre- and post-chemotherapy
Potential Benefits Improved survival, delayed bone complications, reduced bone pain, better quality of life
Common Side Effects Bone marrow suppression, nausea, diarrhea, vomiting, peripheral edema

FAQ

  • What is Radium Ra 223 Dichloride? Radium Ra 223 Dichloride, also known as Xofigo, is a targeted alpha particle-emitting radiopharmaceutical drug used to treat prostate cancer that has spread to the bones. It is given as an intravenous injection and works by delivering radiation directly to bone metastases.
  • How is Radium-223 being studied in clinical trials? Clinical trials are investigating Radium-223 in various ways, including its use alone, in combination with other prostate cancer drugs like enzalutamide or abiraterone acetate, and its effectiveness in different stages of prostate cancer. Researchers are also studying its impact on patients' quality of life, pain relief, and overall survival.
  • What are some potential benefits of Radium-223 treatment? Potential benefits being studied include improved overall survival, delayed time to first symptomatic skeletal event, reduced bone pain, improved quality of life, and decreased levels of alkaline phosphatase (a marker of bone metastasis activity).
  • Are there any side effects associated with Radium-223? Common side effects being monitored in clinical trials include bone marrow suppression (which can lead to anemia, low white blood cell counts, and low platelet counts), nausea, diarrhea, vomiting, and swelling of the legs and feet. Researchers are carefully evaluating the safety profile of Radium-223, especially when used in combination with other treatments.
  • Who might be eligible for clinical trials using Radium-223? Eligibility criteria vary by trial, but generally include men with castration-resistant prostate cancer that has spread to the bones, who may or may not have received prior chemotherapy. Some trials focus on patients with a specific number of bone metastases or those who have or have not received certain prior treatments.

Ongoing Clinical Trials on Radium Ra 223 Dichloride

  • Study on Adding Darolutamide to First-Line Treatment for Patients with Metastatic Castration-Resistant Prostate Cancer Using a Drug Combination

    Recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    Spain

  • Study on the Effect of Metastasis-Directed Therapy with Lutetium (177Lu) Zadavotide Guraxetan in Patients with Advanced Prostate Cancer and Up to 5 Progressive Lesions

    Recruiting

    1 1 1 1
    Investigated diseases:
    Investigated drugs:
    Belgium

  • Study on the Safety of Lutetium (177Lu) Zadavotide Guraxetan and Radium Ra 223 Dichloride for Patients with Bone-Metastatic Prostate Cancer

    Not recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    The Netherlands

  • Study on Radium-223, Docetaxel, and Prednisone for Patients with Bone-Only Metastatic Castration-Resistant Prostate Cancer

    Not recruiting

    1 1 1
    Investigated drugs:
    Italy

  • Study Comparing Radium-223 Dichloride with Abiraterone Acetate, Enzalutamide, and Prednisone in Patients with Advanced Prostate Cancer Spread to the Bone

    Not recruiting

    1 1 1 1
    Investigated drugs:
    Austria Czechia Finland France Germany Hungary +4

  • Study of enzalutamide alone versus enzalutamide with radium-223 combination in patients with bone metastatic castration-resistant prostate cancer with mild or no symptoms

    Not recruiting

    1 1 1 1
    Investigated diseases:
    Investigated drugs:
    Belgium Denmark France Ireland Italy Norway +2

  • Study Comparing Docetaxel Alone and Docetaxel with Radium-223 for Patients with Metastatic Castration-Resistant Prostate Cancer

    Not recruiting

    1 1 1 1
    Investigated diseases:
    Investigated drugs:
    The Netherlands Spain

Glossary

  • Metastatic Castration-Resistant Prostate Cancer (mCRPC): An advanced form of prostate cancer that has spread beyond the prostate to other parts of the body (such as bones) and continues to grow despite treatments that lower testosterone levels.
  • Bone Metastases: Cancer that has spread from its original site to the bones, which is common in advanced prostate cancer.
  • Alpha Particle: A type of ionizing radiation emitted by Radium-223 that can kill cancer cells. Alpha particles have a very short range, which helps limit damage to surrounding healthy tissues.
  • Prostate Specific Antigen (PSA): A protein produced by the prostate gland. Elevated levels in the blood can indicate prostate cancer or its progression.
  • Alkaline Phosphatase (ALP): An enzyme found in the blood that can be elevated in patients with bone metastases. It is often used as a marker to monitor treatment response.
  • Skeletal-Related Event (SRE): A complication of bone metastases that can include bone fractures, spinal cord compression, or the need for surgery or radiation to the bone.
  • FACT-P: Functional Assessment of Cancer Therapy-Prostate, a questionnaire used to assess quality of life in prostate cancer patients.
  • Enzalutamide: An anti-androgen medication used to treat prostate cancer by blocking the effects of testosterone.
  • Abiraterone Acetate: A medication that blocks the production of androgens (male hormones) throughout the body, used to treat advanced prostate cancer.
  • Kilobecquerel (kBq): A unit of radioactivity used to measure the dose of Radium-223, with typical doses around 55 kBq per kilogram of body weight.

References

  1. https://clinicaltrials.gov/study/NCT04489719
  2. https://clinicaltrials.gov/study/NCT02199197
  3. https://clinicaltrials.gov/study/NCT03304418
  4. https://clinicaltrials.gov/study/NCT02442063
  5. https://clinicaltrials.gov/study/NCT02729103
  6. https://clinicaltrials.gov/study/NCT04587427
  7. https://clinicaltrials.gov/study/NCT03325127
  8. https://clinicaltrials.gov/study/NCT02097303