Study on Fracture Risk in Men with mCRPC

London, UK: According to a new study, men with metastatic castration-resistant prostate cancer (mCRPC), particularly those treated with radium-223, are at risk of fracture. The findings of this study were published in the journal Clinical Genitourinary Cancer.

Radium-223 is an alpha-emitting radionuclide that seeks out bone and is used to treat metastatic castration-resistant prostate cancer. When used with abiraterone and prednisolone, radium-223 increases the risk of fracture. It is unknown if males getting radium-223 monotherapy are at risk of fracture.

Adham Hijab and the team conducted the study with the objective to describe the risk of fracture in males who were given radium-223 as a single agent. In addition, the fracture risk in a similar sample of males with mCRPC who were scanned in the same way but did not receive radium-223 was evaluated as a baseline.

This study was a prospective, multicenter phase II trial of radium-223 in 36 males with mCRPC and a reference cohort (n = 36), matched for fracture risk but not treated with radium-223. Whole-body magnetic resonance imaging was used to evaluate bone fractures. The key result was the possibility of additional fractures.

Key Findings

• Radium-223 was administered to 36 individuals in up to six 4-week cycles.
• In 20 patients with a median follow-up of 16.3 months, 74 additional fractures were discovered.
• At 12 months, the freedom from fracture was 56%.
• Prior corticosteroid usage was linked to a higher incidence of fracture in a multivariate study.
• Over a median follow-up of 24 months in the reference cohort (n = 36), 16 additional fractures were observed in 12 individuals. 67% of all fractures occurred at an uninvolved bone in both groups.

In conclusion, men with mCRPC, especially those receiving radium-223, are at risk of fracture and should be treated with a bone health agent to lower the chance of fragility fractures.

Reference

Hijab, A., Curcean, S., Tunariu, N., Tovey, H., Alonzi, R., Staffurth, J., Blackledge, M., Padhani, A., Tree, A., Stidwill, H., Finch, J., Chatfield, P., Perry, S., Mu Koh, D., Hall, E., & Parker, C. (2021). Fracture Risk in Men with Metastatic Prostate Cancer Treated With Radium-223. In Clinical Genitourinary Cancer (Vol. 19, Issue 5, pp. e299–e305). Elsevier BV. https://doi.org/10.1016/j.clgc.2021.03.020