Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer patients sequentially treated wit
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ORIGINAL ARTICLE
Fracture risk and survival outcomes in metastatic castration-resistant prostate cancer patients sequentially treated with abiraterone acetate and RADIUM-223 Orazio Caffo 1 & Viviana Frantellizzi 2 & Marcello Tucci 3 & Luca Galli 4 & Fabio Monari 5 & Sergio Baldari 6 & Cristina Masini 7 & Roberto Bortolus 8 & Gaetano Facchini 9 & Pierpaolo Alongi 10 & Stefania Agostini 11 & Clizia Zichi 3 & Elisa Biasco 4 & Stefano Fanti 12 & Salvatore Pignata 6 & Angelina Filice 13 & Eugenio Borsatti 14 & Sabrina Rossetti 9 & Massimiliano Spada 15 & Enrico Cortesi 2 & Giuseppe De Vincentis 2 Received: 1 November 2019 / Accepted: 27 March 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the fracture risk and survival outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC) who received sequentially abiraterone acetate (AA) and radium 223 [223Ra]RaCl2 in the daily clinical practice. Materials We retrospectively reviewed the records of mCRPC patients who received [223Ra]RaCl2 immediately after progressing during an AA treatment line in everyday clinical practice. Results We reviewed data of a consecutive series of 94 mCRPC patients. Most of the patients (85.1%) received [223Ra]RaCl2 as second- or third-line treatment. [223Ra]RaCl2 treatment was well-tolerated; there were only four cases of grade 3 anaemia, two cases of grade 3 leukopenia and one case of grade 3 neutropenia. The overall fracture rate is 2.1%; one fracture was recorded during the course of [223Ra]RaCl2 treatment, and one was recorded 1 month after its end. The fractures both occurred at metastatic sites. Median OS from [223Ra]RaCl2 start was more than 14 months regardless of the treatment line when [223Ra]RaCl2 was administered. Conclusion The findings of this study show that the treatment with [223Ra]RaCl2 immediately after AA was active and safe with a very low risk of a fracture. Thus, the present observational report makes a valuable contribution to the current debate concerning the risks and benefits of including [223Ra]RaCl2 in the therapeutic algorithm.
This article is part of the Topical Collection on Oncology - Genitourinary * Orazio Caffo [email protected]
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Department of Radiation Oncology, NCI-IRCCS of Aviano, Aviano, Italy
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Departmental Unit of Experimental Uro-Andrological Clinical Oncology, Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Naples, Italy
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Nuclear Medicine Unit, Fondazione Istituto G.Giglio, Cefalù, Italy
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Department of Nuclear Medicine, Santa Chiara Hospital, Trento, Italy
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Department of Nuclear Medicine, S. Orsola Malpighi Hospital, Bologna, Italy
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Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d’Oro, 38100 Trento, Italy
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Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy
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Department of Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
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Department of Medical Oncology, AOU Pisana, Pisa, Italy
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Department of Radio
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