Abstract | BACKGROUND: METHODS: We identified patients who received Ra223 at University of Southern California or Mayo Clinic Arizona. Patients were evaluable for pain response if they had baseline pain score > 0 and at least 1 pain score documented after Ra223 with pain medication use data. Patients were evaluable for pain flare if they had known baseline pain score and at least 2 pain scores documented after Ra223. Pain response was defined as > 2 point decrease in pain on a 10-point scale; flare was defined as > 2 point increase followed by return to baseline or lower. RESULTS: Of 65 patients, 22 (34%) received BST. Median number of doses Ra223 was 5 (range 2-6). Fourteen patients were evaluable for pain response and 34 for pain flare. Eighteen patients received concurrent abiraterone (abi) or enzalutamide (enza), and 16 did not. Pain response occurred in 6/6 (100%) patients who received BST within 1 month prior to first Ra223 dose and 4/8 (50%) patients who did not receive BST. Pain flare occurred in 6/21 patients (29%) without BST and 2/13 (15%) with BST (p = 0.44). 6/10 (60%) patients with pain response had a decline in alkaline phosphatase (ALP) level, but there was no consistent pattern of ALP changes in patients with flare. 8/8 patients with pain response had no PSA decline. 6/8 (75%) and 2/18 (11%) patients on abi/enza had pain response and flare respectively, and 4/6 (67%) and 6/16 (38%) patients without concurrent abi/enza had response/flare. CONCLUSIONS: BST within 1 month prior to first Ra223 dose was associated with increased likelihood of pain palliation and might prevent pain flare. Concurrent use of abi/enza was not associated with increased likelihood of pain response but was associated with decreased likelihood of pain flare.
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Authors | Kelly Khai-Li Yap, William Wong, Lingyun Ji, Susan Groshen, David I Quinn, Alan H Bryce, Tanya B Dorff |
Journal | Cancer treatment and research communications
(Cancer Treat Res Commun)
Vol. 18
Pg. 100114
( 2019)
ISSN: 2468-2942 [Electronic] England |
PMID | 30529990
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2018 Elsevier Ltd. All rights reserved. |
Chemical References |
- Androstenes
- Benzamides
- Bone Density Conservation Agents
- Nitriles
- Phenylthiohydantoin
- Radium-223
- enzalutamide
- abiraterone
- Radium
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Topics |
- Androstenes
(administration & dosage, adverse effects)
- Benzamides
- Bone Density Conservation Agents
(administration & dosage)
- Bone Neoplasms
(drug therapy, radiotherapy, secondary)
- Cancer Pain
(drug therapy, etiology)
- Chemoradiotherapy
(adverse effects)
- Follow-Up Studies
- Humans
- Male
- Nitriles
- Pain Management
- Palliative Care
- Phenylthiohydantoin
(administration & dosage, adverse effects, analogs & derivatives)
- Prognosis
- Prostatic Neoplasms, Castration-Resistant
(drug therapy, pathology, radiotherapy)
- Radium
(adverse effects)
- Retrospective Studies
- Time Factors
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