Ongoing Trials Suggest Benefits of Radium-223 Combos in Prostate Cancer

Video

Early data from ongoing clinical trials suggest the potential safety and efficacy of novel radium-223 combinations as treatment for metastatic castration-resistant prostate cancer.

Future research will look to affirm the overall survival (OS) and safety benefits of radium-223 in combination with agents including docetaxel in metastatic castration-resistant prostate cancer (mCRPC) studies such as the phase 3 DORA trial (NCT03574571), according to Scott T. Tagawa, MD, MS, FACP.

Tagawa, a professor of medicine and urology and medical director of the Genitourinary Oncology Research Program at Weill Cornell Medicine, spoke with CancerNetwork® at the 16th Annual Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies regarding ongoing clinical trials investigating the efficacy of different radium-223 combination therapies in mCRPC.

Transcript:

There are a couple of ongoing phase 3 trials. One is a trial called PEACE III [NCT02194842], which is taking a patient population [with] untreated mCRPC—meaning frontline—with the backbone enzalutamide [Xtandi] with or without radium-223. This trial started with the benefit early on of knowing the phase 3 ERA 223 trial [NCT02043678] results. Early on, they mandated the use of bone health agents. We’ve seen a couple of initial safety presentations at [the American Society of Clinical Oncology Annual Meeting] that demonstrate that there’s no excess fractures to date, although we’re waiting for the overall efficacy results of that study.1

And then a separate combination study, based upon a PCC TC randomized phase 2 study [NCT01106352] led by [Michael J. Morris, MD], [is evaluating] docetaxel and radium-223. Again, [it] makes sense targeting different compartments and also [with the] radiosensitizing properties of the taxane. That randomized phase 2 trial showed improvements in efficacy with lower toxicity to the combination.2 Now, the combination is an adjusted dose and schedule, so docetaxel at 60 mg/m2 and radium-223 every 6 weeks to match with the docetaxel. In any case, that has led to the phase 3 DORA trial, which is ongoing [with] accrual, with probably more than a third still left to go. But what we’re hoping to see is an [OS] benefit, maybe with an improved safety profile.

References

  1. Tombal BF, Loriot Y, Saad F, et al. Decreased fracture rate by mandating bone-protecting agents in the EORTC 1333/PEACE III trial comparing enzalutamide and Ra223 versus enzalutamide alone: An interim safety analysis. J Clin Oncol. 2019;37:5007. doi:10.1200/JCO.2019.37.15_suppl.5007
  2. Morris MJ, Loriot Y, Sweeney CJ, et al. Radium-223 in combination with docetaxel in patients with castration-resistant prostate cancer and bone metastases: a phase 1 dose escalation/randomised phase 2a trial. Eur J Cancer. 2019;114:107-116. doi:10.1016/j.ejca.2019.04.007

Newsletter

Stay up to date on recent advances in the multidisciplinary approach to cancer.

Recent Videos
Extravasation with beta emitters may elicit more drastic adverse effects due to their higher radiation dose.
Increasing the use of patient-reported outcomes may ensure that practitioners can fully ascertain the impact of treatment for rare lymphomas.
Photographic and written documentation can help providers recognize inflammatory breast cancer symptoms across diverse populations.
The use of guideline-concordant care in breast cancer appears to be more common in White populations than Black populations.
Retrospective and real-world registry studies may be necessary to guide clinical decision-making for rarer lymphomas with insufficient prospective data.
Extravasation results in exposing healthy tissue to radiation, which can be highly dosed depending on the isotope used for treatment.
4 experts in this video
4 experts in this video
Ongoing studies seek to evaluate immunotherapy in earlier lines of therapy for patients with early-stage Hodgkin lymphoma.
Related Content