Radionuclide therapy for bone metastases by drugs based on Re-188.

The systemic radionuclide therapy with bone affinity substances is an effective therapy in bone palliative treatment. Studies with radiolabeled Bisphosphonate or strontium-89 show reduction of pain in 70-80% and about 20% of treated patients are pain-free. The generator product rhenium-188 represents an interesting radionuclide for bone pain palliation. It is readily available and with appropriate patient numbers is very cost-effective. Radiopharmaceuticals with Re-188 show a comparable effectiveness in bone pain palliation and bone marrow toxicity as the other known radioactive Bisphosphonate. Repeat courses of treatment with rhenium-188 HEDP even a slightly increased survival could be observed. Using therapy with alpha emitters Radium-223 in prostate cancer patients with bone metastases there was observed a prolongation of survival by 3,6 months compared with placebo. Two drugs are created in Russia on the basis of Re-188. Phosphoren is an analog of Re-188-HEDP. It showed properties similar to them in clinical studies. Complex Re-188-zoledronic acid (Zoleren) is a unique development that combines the therapeutic effect of zoledronic acid and Re-188.