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Definition |
The only bone-specific drug that is associated with a survival benefit is alpharadin, a radium 223 a-emitter. In a large phase III trial (ALSYMPCA), 921 patients with symptomatic CRPC, who failed or were unfit for docetaxel therapy, were randomised to six injections of 50 kBq/kg alpharadin or placebo. The primary end-point was OS. Alpharadin significantly improved OS by 3.6 months (HR = 0.70; p < 0.001). It was also associated with prolonged time to first skeletal event, improvement in pain scores and improvement in QoL. The associated toxicity was minimal, especially haematologic toxicity, and did not differ significantly from that in the placebo
arm.
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