Dr. Dreicer Discusses Challenges of Radium-223 in Prostate Cancer

Robert Dreicer, MD, associate director for clinical research and deputy director of the University of Virginia Cancer Center, discusses the questions that surround radium-223 dichloride (Xofigo).

Radium-223 is one of the 2 approved therapies in advanced prostate cancer that is not an AR-targeted therapy. Combining agents like enzalutamide (Xtandi) and radium-223 is an option, because it could not only potentially get a better and prolonged response, but it is an economically viable option for testing, says Dreicer.

Due to its sparing of the bone marrow and relatively well tolerated profile, it lends itself to integration earlier in the disease course. Due to these factors, the future of radium-223 lies in combination therapies, predicts Dreicer.

Challenges with radium-223 still exist though, as there isn’t objective antitumor activity, it’s a bone-targeted therapy, and PSA responses are not common. Dreicer says the agent needs to be studied further to decide the optimal way in which to integrate it into the management paradigm.