Daniel J. George, MD, Director of Genitourinary Oncology, Duke Cancer Institute, discusses how radium-223 is used to treat patients with metastatic castration-resistant prostate cancer.

Patients with pain caused by inflammation of bony metastases are ideal candidates for radium-223, George says, and they do not have to be on narcotics to qualify.

George says radium-223 will also work in patients that have asymptomatic bony lesions. Future studies will take place to see if radium-223 can be used in combination with other hormonal therapies, immunotherapies, or targeted therapies. Radium-223 is also being mixed with different chemotherapy combinations, which could add an overall benefit for the patients, George says.

With the approval of radium-223, George says, there are now a number of different therapies and different actions of therapies that will prolong survival. Radium-223 lends itself to be used in combinations and can be used in different approaches, which is very helpful for a patient population whose estimated median survival is approximately three years. Radium-223 lends itself to be used in combinations because it is easy to use and has a relatively low toxicity profile.

George says there will be studies done in the future to find out where radium-223 fits in, but he believes that it will probably be an alternative to docetaxel.