Xofigo (radium Ra-223 dichloride) / Bayer - LARVOL DELTA

Therapeutic Advances in Metastatic Prostate Cancer: A Journey from Standard of Care to New Emerging Treatment. (PubMed, Int J Mol Sci) - "We detail the evidence supporting the integration of systemic agents like abiraterone, enzalutamide, and darolutamide into both hormone-sensitive and castration-resistant settings. Furthermore, we highlight the expanding role of radioligand therapies, including radium-223 and Lutetium-177-labeled PSMA-617 (Lu-PSMA-617), as well as the growing impact of PARP inhibitors in genomically selected patients. The emergence of theranostic strategies and next-generation sequencing has paved the way for personalized treatment algorithms, moving toward a truly precision oncology model in PCa. This comprehensive review synthesizes current therapeutic strategies, clinical trial evidence, and future directions aimed at optimizing outcomes and quality of life for patients with advanced prostate cancer."

Journal • Review • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • BRCA1 • BRCA2 • PTEN • TP53

Rad2Nivo: Study of Nivolumab in Combination w Radium-223 in Men w Metastatic Castration Resistant Prostate Cancer (clinicaltrials.gov) - P1 | N=39 | Active, not recruiting | Sponsor: University of Utah | Trial primary completion date: Jul 2025 ➔ Feb 2025

Trial primary completion date • Tumor mutational burden • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Adenocarcinoma • Prostate Cancer • Solid Tumor

Effectiveness and Safety of Radium-223 for Bone-Metastatic Castration-Resistant Prostate Cancer: The KYUCOG-1901 Study. (PubMed, Cancer Sci) - "Early initiation in less symptomatic patients with lower disease burden may maximize benefit, and integration with subsequent therapies appears feasible. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000040358."

Journal • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Prognostic factors for overall survival in patients with metastatic castration-resistant prostate cancer treated with radium-223: a meta-analysis of real-world evidence. (PubMed, Front Oncol) - "Real-world data confirm Ra-223's survival benefit is closely associated with treatment completion and baseline clinical factors. The findings support risk-stratified patient selection and tailored management in mCRPC."

Biomarker • HEOR • Journal • Real-world evidence • Retrospective data • Review • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Dual-locked targeted alpha-emitter enhanced tumor immunotherapy via Diels-Alder reaction-based self-immolative molecular cage strategy. (PubMed, Mil Med Res) - "These findings underscore the potential of dual-locked pretargeted strategies to advance TAT by improving therapeutic efficacy and addressing the critical challenge of radionuclide leakage, paving the way for next-generation precision-targeted radiopharmaceuticals."

Journal • Oncology

PARP Inhibitors in Metastatic Castration-resistant Prostate Cancer: Rationale, Mechanisms, and Clinical Applications. (PubMed, Eur Urol Oncol) - "Promising results have led to the approval of several PARPi agents as monotherapy or in combination with ARPIs in selected or unselected patients when chemotherapy is not clinically indicated. However, some questions remain regarding patient selection and treatment sequencing."

Journal • Review • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • BRCA1 • BRCA2 • CDK12 • PALB2

A plain language summary of the EORTC 1333/PEACE-3 study of enzalutamide alone vs enzalutamide plus radium-223 in patients with metastatic castrationresistant prostate cancer (mCRPC) and bone metastases. (PubMed, Future Oncol) - No abstract available

Journal • Castration-Resistant Prostate Cancer • Esophageal Cancer • Gastric Cancer • Gastroesophageal Junction Adenocarcinoma • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

French recommendations from the AFU Cancer Committee for prostate cancer 2025 Summary of changes. (PubMed, Fr J Urol) - "This 2025 summary of changes of French recommendations on PCa should help physicians to stay up-to-date with recent evolutions and aim to improve the management of PCa patients."

Journal • Review • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • Urology

Comparative Efficacy of First-Line (1L) Therapies for Patients With Asymptomatic/Mildly Symptomatic Metastatic Castration-Resistant Prostate Cancer (mCRPC): An Updated Systematic Literature Review (SLR) and Bayesian Network Meta-Analyses (NMAs) (ISPOR-EU 2025) - "Talazoparib plus enzalutamide (TALA+ENZA) was the top-ranked treatment for rPFS (SUCRA: 89.6%) and OS (SUCRA: 84.4%)...In sensitivity analysis for OS (22 RCTs; 20 treatments), a non-standard docetaxel regimen, docetaxel 50 mg/m² plus prednisolone (DOC50+PL10; SUCRA: 89.9%), was the top-ranked treatment, followed by radium-223 plus enzalutamide (Ra55+ENZA; SUCRA: 87.7%), two treatments originally excluded from the base case. This NMA provides a comprehensive indirect comparison of 1L treatments for mCRPC. This NMA provides a comprehensive indirect comparison of 1L treatments for mCRPC. TALA+ENZA ranked highest across all assessed outcomes in base case analyses and remained among the top treatments in sensitivity analyses. These findings can support evidence-based decision-making in selecting optimal 1L treatments for patients with mCRPC."

Clinical • Metastases • Review • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

PRE-RADIOTHERAPY TUMOR EXTRACELLULAR VESICLES FOR RISK STRATIFICATION IN OLIGORECURRENT PROSTATE CANCER: SECONDARY ANALYSIS OF THE RAVENS TRIAL (SUO 2025) - "In this study, we evaluated PSMA + Extracellular Vesicles as a prognositc biomarker for risk stratification for patients treated with SABR or SABR plus radium 223 from the RAVENS trial. Interestingly, the previously published high/low cutpoint for PSMA + Extracellular Vesicles was prognostic for PSMA PET distant metastasis free survival however was not predictive of biochemical progression. Conversely, PSA was prognostic for biochemical progression but was not predictive for PSMA PET distant metastasis free survival."

Genito-urinary Cancer • Hormone Sensitive Prostate Cancer • Oncology • Prostate Cancer • Solid Tumor • STEAP1

Clinical efficacy of radium-233 in metastatic castrate resistant prostate cancer with symptomatic bone metastases: A meta-analysis (EMUC 2025) - "Treatment intervention involved the administration of radium-223, with comparison being either placebo or conventional treatment (e.g., abiraterone acetate and prednisone). Conclusions We found that by utilizing radium 233 for symptomatic bone metastases, there are no statistically significant differences in the main outcomes between the control and mCRPC treatment groups. Moreover, additional research with larger sample sizes and more RCTS is required to enhance our understanding of Radium 223's role in this therapeutic setting."

Retrospective data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Heavy Alkaline Earth Radiometals for Cancer Theranostics: Coordination and Radiochemistry of Radium-223 and Barium-131 with Kryptofix 22-Based Chelators. (PubMed, Inorg Chem) - "Concentration-, temperature-, pH-, and time-dependent radiolabeling were carried out using 223Ra derived from Xofigo residues and cyclotron-produced 131Ba. Although quantitative 223Ra/131Ba incorporation was not achieved, this work expands the scarce coordination chemistry and radiochemistry of the two heaviest alkaline earth (radio)metals."

Journal • Oncology

ProGAP: Prostate cancer care disparity analysis project (ESMO 2025) - P | "In LMICs/LICs settings, reimbursement for LHRH agonist, docetaxel, and ARPi was incomplete, resulting in 14.3% to 42.9% of patients incurring out-of-pocket expenditure. Also, Access to PARP inhibitors, 177Lu-PSMA-617, and Radium-223 was very low, 7.1–21.4%...Conclusions ProGAP highlights persistent global disparities in prostate cancer care, with limited access in LMICs/LICs. Targeted policy action is urgently needed (NCT06612034)."

Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

LuRa: Efficacy and Tolerability of Radium-223 Following [177Lu]Lu-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer (ESMO 2025) - "Careful patient selection and close monitoring during therapy are required. Legal entity responsible for the study MAYO CLINIC."

Clinical • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

PROshot: Regional Nodal Irradiation After Pathologic Complete Response, Adjuvant Immunotherapy for High-Risk Skin Cancer, Adjuvant Therapy for Biliary Tract Cancer, and Radium-223 Plus Androgen Receptor Pathway Inhibition for Metastatic, Castration Resistant Prostate Cancer. (PubMed, Pract Radiat Oncol) - No abstract available

Journal • Biliary Cancer • Biliary Tract Cancer • Castration-Resistant Prostate Cancer • Genetic Disorders • Genito-urinary Cancer • Oncology • Prostate Cancer • Skin Cancer • Solid Tumor

Real-world treatment patterns in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with androgen receptor pathway inhibitor (ARPI) or docetaxelProstACT Global: A phase 3 study of Lutetium (Lu177) rosopatamab tetraxetan plus standard of care vs standard of care alone in patients with metastatic castration-resistant prostate cancer (PCF 2025) - "BACKGROUND: Patients with mCRPC whose disease progressed on an ARPI have a poor prognosis, with median overall survival of <2 years (Sayegh, Eur Urol Focus 2023). These real-world data show that ARPIs remain the most common 1L and 2L treatment in patients with mCRPC despite prior ARPI and/or docetaxel alongside androgen deprivation therapy for mHSPC or nmCRPC. TABLE. Treatment regimens by line of therapy in patients with mCRPC 1L regimen (N=510), 2L regimen (N=188), 3L regimen (N=80), n (%) n (%) n (%) ARPI*,† 289 (56.7) ARPI*,† 83 (44.1) Taxane‡ 23 (28.8) Abiraterone 149 (29.2) Abiraterone 35 (18.6) ARPI*,† 21 (26.3) Enzalutamide 124 (24.3) Enzalutamide 34 (18.1) Enzalutamide 10 (12.5) Taxane‡ 86 (16.9) Taxane‡ 50 (26.6) Abiraterone 8 (10.0) Abiraterone + Cabazitaxel + 16 (3.1) Olaparib 9 (4.8) 8 (10.0) Docetaxel Carboplatin 1 Olaparib 16 (3.1) Lutetium-177 7 (3.7) Lutetium-177 6 (7.5) Abiraterone + Sipuleucel-T 15 (2.9) 4 (2.1) Radium-223 5 (6.3) Sipuleucel-T Other..."

Clinical • HEOR • Metastases • P3 data • Real-world • Real-world evidence • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Hormone Sensitive Prostate Cancer • Oncology • Prostate Cancer • Solid Tumor

Combined Radium-223 and Lutetium-177 PSMA-I&T in patients with metastatic castration-resistant prostate cancer: first analysis of the single-center phase I/II AlphaBet trial (PCF 2025) - P1/2 | "19 patients (53%) received prior docetaxel. Funding Acknowledgements Supported by a Special Challenge Award from the Prostate Cancer Foundation, Bayer for radium-223 supply and funding, and a National Health and Medical Research Council Investigator Grant. Conflicts of Interest Disclosure Statement Bayer provided institutional funding and radium-223 supply"

Clinical • Metastases • P1/2 data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Improving patient management in mCRPC: Combined in vitroalpha particle and x-ray radiotherapies with Enzalutamide (AACR-NCI-EORTC 2025) - "The first and only approved alpha particle emitter is Radium-223 dichloride, which targets the bone tumor microenvironment, but there is great academic and clinical interest in novel targeted alpha emitters in various stages of development and trial, many of which target the prostate-specific membrane antigen (PSMA)...High energy α-emitting radionuclides appended to short peptides or monoclonal antibodies establish the backbone of targeted alpha therapies—recent methods include 225Ac-PSMA-617, 213Bi-PSMA-617, 211At-PSMA-pentanedioic acid, and 227Th-PSMA-IgG1...AR inhibitors disrupt the DNA-repair function, and are under investigation for combined use with targeted radiotherapies. Our aim is to improve the therapeutic potential of alpha particle and combination radiotherapies in improving mCRPC patient management."

Preclinical • Castration-Resistant Prostate Cancer • Oncology • Osteosarcoma • Prostate Cancer • AR • FOLH1

Combined treatment with radium-223 (RAD) and enzalutamide (ENZ) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): Insights from the global REASSURE study (ESMO 2025) - P, P3 | "Incidence of fractures was slightly higher in ALL pts (10%) with fewer pts receiving concomitant BPAs (denosumab 28% and zoledronic acid 13%)...Table: 2401P ENZ/RAD (N=45) ALL Pts (N=1,472) Median time since initial diagnosis of bone metastases to study entry, months 14 23 Median time since castration resistant cancer to study entry, months 7 13 Extent of disease, % Bone only metastases 80 81 Bone metastases + lymph node only 9 13 Disease burden, % 20 metastases but not Superscan 18 20 Superscan 4 6 Laboratory values, median ALP (U/L) 131 133 PSA (ng/mL) 33 59 Prior abiraterone, % 40 48 Prior docetaxel, % 16 39 Prior Sipuleucel-T, % 18 9 Conclusions In this subgroup of pts treated with combined ENZ/RAD in a real-world setting, there was no new safety signal...Pts received ENZ/RAD earlier in the disease course based on time from mCRPC, time from initial diagnosis of bone metastases and prior docetaxel. Fracture incidence was low in ENZ/RAD, and the majority of pts..."

Clinical • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Real-World Experience with Radium-223 in metastatic castration-resistant prostate cancer: A single-center retrospective study (ESMO 2025) - "Prior to Ra-223, 88% of patients had received androgen receptor pathway inhibitors, 59% docetaxel and 26% cabazitaxel. These findings support the integration of Ra-223 into routine practice for bone-predominant mCRPC. Legal entity responsible for the study The authors."

Metastases • Real-world • Real-world evidence • Retrospective data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Bone fractures and prior abiraterone use in men treated with Radium-223 and enzalutamide combination for castration resistant prostate cancer (CRPC) with bone metastases(m): A real-world observational study (ESMO 2025) - "Conclusions Prior abiraterone use was not associated with bone fracture in men treated with enza + Ra-223 combination therapy for mCRPC. Legal entity responsible for the study The authors."

Clinical • Observational data • Real-world • Real-world evidence • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Real-world experience with radium-223 dichloride in mCRPC: A single-center retrospective analysis (ESMO 2025) - "Prior to Ra-223, 54% had received ≥2 therapy lines, with 86.7% exposed to docetaxel and 25.3% also to cabazitaxel. The possibility of further treatments following Ra-223 is of great interest and warrants further investigation to better understand its exact placement within the therapeutic sequence for mCRPC management. Legal entity responsible for the study The authors."

Real-world • Real-world evidence • Retrospective data • Castration-Resistant Prostate Cancer • Oncology • Prostate Cancer

A ten-year perspective on Radium-223 (Ra-223) in metastatic castration-resistant prostate cancer (mCRPC): Survival, symptom control, and lessons learned (ESMO 2025) - "Survival outcomes were primarily influenced by completion of the full treatment regimen and prior opioid use, underscoring the impact of treatment adherence and baseline clinical status on prognosis. Legal entity responsible for the study David Marmolejo."

Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

PULMONARY TUMOR THROMBOTIC MICROANGIOPATHY IN A PATIENT WITH DIFFUSELY METASTATIC PROSTATE ADENOCARCINOMA (CHEST 2025) - "CASE PRESENTATION: A 56-year-old male with diffusely metastatic prostate adenocarcinoma and surgically stabilized thoracic cord compression, receiving treatment with abiraterone acetate and radium-223 through a clinical trial, history of pulmonary embolism (PE) previously on apixaban presented with pain, weakness, worsening pancytopenia, hemolytic anemia, dyspnea and hypoxemia requiring supplemental oxygenation...Drug pneumonitis was also considered, but since has not been described in literature with Radium 223 therapy, patient's low dose chronic prednisone therapy was not escalated... While clinical PTTM diagnosis is difficult and confounded by an extensive list of potentially treatable differential diagnoses, PTTM is a fatal process. Although there are many supportive treatments and treatments directed at malignancy complicated by PTTM, one must weigh their benefits against risks."

Clinical • Metastases • Anemia • CNS Disorders • Congestive Heart Failure • Heart Failure • Hematological Malignancies • Infectious Disease • Lung Cancer • Oncology • Pneumonia • Prostate Adenocarcinoma • Prostate Cancer • Pulmonary Arterial Hypertension • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Thrombocytopenic Purpura • HP

A phase I/II trial of combined Radium-223 and Lutetium-177 PSMA-I&T in patients with metastatic castration-resistant prostate cancer (mCRPC): First analysis of the AlphaBet trial (ESMO 2025) - P1/2 | "19 pts (53%) received prior docetaxel. Conclusions The combination of LuPSMA and 223 Ra is safe and well-tolerated, demonstrating antitumour activity in pts with progressive mCRPC and bone metastases. The findings support further evaluation of combined alpha/beta-emitting approaches."

Clinical • Metastases • P1/2 data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor