Chemotherapy following radium-223 dichloride treatment in ALSYMPCA.
Prostate
; 76(10): 905-16, 2016 07.
Article
en En
| MEDLINE
| ID: mdl-27004570
ABSTRACT
BACKGROUND:
Radium-223 prolongs overall survival in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases, regardless of prior docetaxel. Whether or not chemotherapy can be safely administered following radium-223 treatment is of clinical importance. An exploratory analysis of prospectively collected data, from the ALSYMPCA (ALpharadin in SYMptomatic Prostate CAncer) patient subgroup who received chemotherapy after radium-223 or placebo treatment, was conducted to evaluate the safety and efficacy of chemotherapy following radium-223.METHODS:
In ALSYMPCA, CRPC patients with symptomatic bone metastases and no visceral metastases were randomized 21 to receive six injections of radium-223 (50 kBq/kg IV) or placebo plus best standard of care, stratified by prior docetaxel, baseline alkaline phosphatase, and current bisphosphonate use. In this exploratory analysis, chemotherapy agents administered following study treatment were identified; timing and duration were calculated. Hematologic safety was reviewed, and overall survival analyzed.RESULTS:
Overall, 142 radium-223 and 64 placebo patients received subsequent chemotherapy; most common were docetaxel (70% radium-223, 72% placebo) and mitoxantrone (16% radium-223, 20% placebo). The majority of patients (61% radium-223, 58% placebo) had received prior docetaxel. Radium-223 patients started subsequent chemotherapy later than placebo patients; chemotherapy duration was similar between groups. In radium-223 and placebo patients receiving subsequent chemotherapy, median hematologic values (hemoglobin, neutrophils, and platelets) remained nearly constant up to 18 months following start of chemotherapy, regardless of prior docetaxel treatment. A low percentage of patients in both groups had grades 3-4 hematologic values (<10%). Platelet count decline, from last measurement before chemotherapy, was numerically greater in radium-223 versus placebo patients. Median overall survivals from start of chemotherapy were 16.0 and 15.8 months following radium-223 and placebo, respectively.CONCLUSIONS:
Chemotherapy following radium-223, regardless of prior docetaxel, is feasible and appears to be well tolerated in patients with CRPC and symptomatic bone metastases. Prostate 76905-916, 2016. © 2016 The Authors. The Prostate published by Wiley Periodicals, Inc.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Radio (Elemento)
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Neoplasias de la Próstata Resistentes a la Castración
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Antineoplásicos
Tipo de estudio:
Clinical_trials
Límite:
Aged
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Aged80
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Humans
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Male
/
Middle aged
Idioma:
En
Año:
2016
Tipo del documento:
Article