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New Treatment Approach in Men with Advanced Prostate Cancer

By Ted Ling, MD
Xofigo works by binding to minerals in the bone and delivering radiation treatment directly to prostate cancer within the bone.

Xofigo (Radium-223 dichloride) is a novel radiopharmaceutical treatment, the first of its kind that has been shown to improve cancer survival in certain men with metastatic prostate cancer. It is a promising treatment which may be effective when other treatments have failed.

Prostate cancer can often be detected at a very early stage with routine screening methods. Unfortunately, there are still many instances when prostate cancer is not found until it has spread, or metastasized, from the prostate to other parts of the body. Furthermore, the American Cancer Society estimates that 50% of men diagnosed with localized prostate cancer will still develop metastatic prostate cancer during their lifetime.

Anti-testosterone therapy is the primary treatment for metastatic prostate cancer. Treatments that lower testosterone can slow disease progression. However, prostate cancer can eventually become resistant to anti-testosterone therapy. These resistant cases are referred to as metastatic castrate-resistant prostate cancers (mCRPC). Prostate cancer frequently metastasizes to lymph nodes or other organs, but among the most common sites of spread is bone which can be extremely painful.

The spread of cancer into bone is the primary cause of ill health and poor quality of life in men with mCRPC. This is where Xofigo’s unique mechanism of tumor-directed therapy has shown the greatest benefit.

Xofigo is administered to men with mCRPC in the bones that has not yet spread to other organs. Xofigo has been approved by the FDA, and its mechanism of action lends a very low toxicity profile compared to other radiopharmaceuticals. It works by binding specifically to minerals in the bone and delivering the radiation treatment directly to the prostate cancer within the bone. Xofigo differs greatly from two other radiopharmaceuticals frequently used to treat metastatic prostate cancer, Quadramet (Samarium-153) and Metastron (Strontium-89). While Quadramet and Metastron utilize beta particles, Xofigo utilizes alpha particles which travel a much shorter distance of only 2-10 cell diameters. This allows Xofigo to deliver a more conformal radiation dose, thereby maximizing the therapeutic effect to bone while largely sparing adjacent tissues and organs.

Aside from demonstrating improved prostate cancer survival, Xofigo was also found to improve quality of life for men with mCRPC. It has been shown to reduce bone pain and help prevent further metastatic disease in the bone. Most important, however, is that Xofigo may be administered in combination with other chemotherapies and systemic treatments. Xofigo also does not interfere with external beam radiation therapy and other targeted therapies. Together they can work together to attack mCRPC on multiple fronts.

Xofigo is uniquely suited for many patients with metastatic castrate-resistant prostate cancer. It has a relatively low side effect profile and can overlap with other prostate cancer drugs. Be sure to ask about Xofigo as a potential treatment option.

Dr. Ling is a board-certified radiation oncologist with 21st Century Oncology based in Palm Desert, Rancho Mirage, and Yucca Valley and a member of Desert Doctors. For questions, please contact (760) 200.8777 or visit socal.21co.com/local. www.DesertDoctors.com

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