Aprile C, Persico MG, Lodola L, Buroni FE. Radium-223 and metastatic castration-resistant prostate cancer: All that glitters is not gold. World J Radiol 2016; 8(10): 816-818 [PMID: 27843540 DOI: 10.4329/wjr.v8.i10.816]
Corresponding Author of This Article
Carlo Aprile, MD, Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, v.le Golgi 19, 27100 Pavia, Italy. c.aprile@smatteo.pv.it
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Field Of Vision
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2016; 8(10): 816-818 Published online Oct 28, 2016. doi: 10.4329/wjr.v8.i10.816
Radium-223 and metastatic castration-resistant prostate cancer: All that glitters is not gold
Carlo Aprile, Marco G Persico, Lorenzo Lodola, Federica E Buroni
Carlo Aprile, Marco G Persico, Lorenzo Lodola, Federica E Buroni, Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Marco G Persico, Scuola Universitaria Superiore IUSS Pavia, 27100 Pavia, Italy
Author contributions: Aprile C wrote the manuscript; Aprile C, Persico MG, Lodola L and Buroni FE collected the material and discussed the topic.
Conflict-of-interest statement: Nothing to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlo Aprile, MD, Nuclear Medicine Unit, Department of Oncohaematology, Fondazione IRCCS Policlinico San Matteo, v.le Golgi 19, 27100 Pavia, Italy. c.aprile@smatteo.pv.it
Telephone: +39-340-6415480 Fax: +39-038-2501669
Received: April 30, 2016 Peer-review started: May 3, 2016 First decision: July 6, 2016 Revised: August 4, 2016 Accepted: August 27, 2016 Article in press: August 29, 2016 Published online: October 28, 2016
Abstract
After being approved by the National Drug Agency in several countries, Radium-223 (Ra-223) is gaining wide acceptance in the treatment of bone metastatic castration resistant prostate cancer. The exact mechanism of action remain unclear: The established model of direct alpha-particle irradiation from the remodelling bone surface, where Ra-223 accumulates, surrounding the tumor foci can explain a lethal effect only on metastatic microdeposits, but not on higher tumor burden. According to the “pre-metastatic niche model”, it is likely that Ra-223 targets several non-tumoral cell types of the tumor microenvironment involved in the complex mechanism of cancer bone homing and colonization. A deeper insight into this hypothetical mechanism will lead to a more accurate dosimetric approach and to find optimal sequencing and/or combination with the other therapeutic options.
