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Targeted α-Particle Therapy of Bone Metastases in Prostate Cancer

Jadvar, Hossein MD, PhD, MPH, MBA*; Quinn, David I. MD, PhD

doi: 10.1097/RLU.0000000000000290
Review Article

Medical oncology is moving toward personalized and precision treatments. This evolution is spearheaded by ongoing discoveries on the fundamental machinery that controls tumor and hosts microenvironment biological behavior. α-Particles with their high energy and short range had long been recognized as potentially useful in the treatment of cancer. More than a century after the discovery of radium by the Curies, 223Ra dichloride is now available in the expanding armamentarium of therapies for metastatic castration-resistant prostate cancer. This advance occurs in the context of several other novel therapeutics in advanced prostate cancer that include more effective androgen receptor pathway inhibition, better chemotherapy, and immunotherapy. We present a concise review on the therapeutic use of 223Ra dichloride in this clinically important setting including excerpts on the radium history, physical properties, the alpharadin in symptomatic prostate cancer clinical trial, and practical information on its use in the clinic. It is anticipated that, with the current emergence of 223Ra as a viable form of therapy, interest in and use of α-particle therapy in the management of cancer will grow.

From the Divisions of *Nuclear Medicine, Department of Radiology, and †Cancer Medicine, Department of Medicine, Kenneth J. Norris Jr. Comprehensive CancerCenter, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA.

Received for publication September 6, 2013; revision accepted September 19, 2013.

Conflicts of interest and sources of funding: Supported by the National Institutes of Health, National Cancer Institute, grants R01-CA111613 and R21-142426. Dr David I. Quinn is on the Scientific Advisory Board of Bayer Healthcare/Algeta.

Reprints: Hossein Jadvar, MD, PhD, MPH, MBA, Keck School of Medicine of USC, University of Southern California, 2250 Alcazar St, CSC 102, Los Angeles, CA 90033. E-mail: jadvar@med.usc.edu.

© 2013 by Lippincott Williams & Wilkins