Universität zu Köln

Koenig, F., Strauss, A., Johannsen, M., Mommsen, C., Fricke, E., Klier, J., Mehl, S., Pfister, D., Sahlmann, C. -O., Werner, A. and Goebell, P. J. (2020). Radium-223 for the treatment of metastatic castration-resistant prostate cancer (mCRPC) The androgen receptor-independent active agent in the therapeutic sequence. Urologe, 59 (1). S. 53 - 65. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

Background Radium-223 improves overall survival and preserves quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC) and symptomatic bone metastases and no known visceral metastases. Radium-223 can be used in combination with a luteinizing hormone releasing hormone (LHRH) analogue and as part of a sequential treatment scheme if disease progresses after at least two prior lines of systemic mCRPC therapies or if no other available systemic treatment is eligible. Objectives Today physicians are faced with a previously unknown multitude and complexity of options for the treatment of mCRPC. An increasing number of clinical trials contribute to the dynamics of the therapeutic landscape. Radium-223 was approved for mCRPC treatment in 2013. Up to now the recommendations of use have been adjusted several times. Highlighting recent clinical trials and practice, this paper explores the position of radium-223 within the therapeutic sequence and outlines key elements for the interdisciplinary cooperation between uro-oncologists and nuclear medicine specialists. Results The mode of action of radium-223 does not depend on the androgen receptor (AR) pathway. Thus, it is an option in the therapeutic sequence when the efficacy of other agents is reduced by resistance. Furthermore, the efficacy of prior or subsequent medications are neither reduced nor enhanced by radium-223. The opportunity of an AR-independent and survival-prolonging medication should be taken as soon as the indication criteria are met because the incidence of visceral metastases increases during disease progression. According to current mCRPC guidelines, the osteoprotective use of bisphosphonates or denosumab is recommended, before treatment with radium-223 is started or resumed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koenig, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauss, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Johannsen, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mommsen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fricke, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klier, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehl, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sahlmann, C. -O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Werner, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Goebell, P. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-351611
DOI:	10.1007/s00120-019-01052-4
Journal or Publication Title:	Urologe
Volume:	59
Number:	1
Page Range:	S. 53 - 65
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0563
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PHASE-3 ALSYMPCA TRIAL; BONE METASTASES; DOUBLE-BLIND; DICHLORIDE; SAFETY; EFFICACY; RA-223 Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/35161