Radium 223 – Early Beatson Experience


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Norma Sidek1,Azmat Sadozye1,Abdulla Alhasso1,Jan Wallace1,Balaji Venugopal1,Stephen McKay1,Ross Carruthers1,Carolynn Lamb1,David Dodds1,Gail Buchanan1,Gerry Gillian2,Almudena Cascales1,Iain Kerr2,Caroline Findlay2,Hilary Glen1,Nicholas MacLeod1,Rob Jones1,Martin Russell3
1Beatson West of Scotland Cancer Centre,2Gartnavel General Hospital,3Forth Valley Royal Hospital

Abstract

Background

Radium 223 treatment for bony only metastatic disease from metastatic castrate resistant prostate cancer (mCRPC) has been available only in England through the Cancer Drugs Fund (CDF) which cease later following the delisting by the CDF. Radium 223 received approval from Scottish Medicines Consortium (SMC) on 13 October 2015. Beatson West of Scotland Cancer Centre started delivering Radium 223 treatment in May 2016 to mCRPC.  We share our early experience  within clinical service context.

Method

We collected data on the 18 patients with metastatic prostate cancer who had completed all 6 cycles of Radium 223 treatment including background information of initial PSA (iPSA) at diagnosis, clinical trials participation prior to treatment, types of first , second and third line treatment received, if palliative radiotherapy was delivered within 12 weeks prior to Radium 223 treatment, prior treatment with bisphosphonates, median time from the last Radium223 treatment to time of death and reasons for stopping treatment.

Results

Majority had iPSA of less than 50, 5 patients had been involved with clinical trials prior, majority received prior Docetaxel treatment as first line and Enzalutamide as second line therapy, 5 patients who needed palliative radiotherapy within 12 weeks prior and 7 patients received bisphosphonates prior to palliative radiotherapy.

Mean survival was 45 days from the end of Radium223 treatment to time of death and 9 patients completed all 6 cycles of treatments successfully.

Conclusion

Our early experience with Radium 223 treatment post marketing indicates that this is feasible option. However we have not yet replicated the ALSYMPCA trial results in our experience. We postulate that this is either due to patient selection, long waiting time from  suitability to Radium223 and the treatment to become available in our centre.

We are in the process of analysis the full one year results and will be updating in future conferences