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For: Takeda K, Kawasaki Y, Sakayauchi T, Takahashi C, Katagiri Y, Tanabe T, Ishikawa Y, Fujimoto K, Kubozono M, Kozumi M, Abe K, Narazaki K, Tasaka S, Umezawa R, Yamamoto T, Takahashi N, Suzuki Y, Kishida K, Omata S, Ito A, Jingu K. Clinical significance of completion of radium-223 treatment and acute adverse events in patients with metastatic castration-resistant prostate cancer. Asia Ocean J Nucl Med Biol 2023;11:13-22. [PMID: 36619192 PMCID: PMC9803628 DOI: 10.22038/aojnmb.2022.67136.1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 01/10/2023]

For:	Takeda K, Kawasaki Y, Sakayauchi T, Takahashi C, Katagiri Y, Tanabe T, Ishikawa Y, Fujimoto K, Kubozono M, Kozumi M, Abe K, Narazaki K, Tasaka S, Umezawa R, Yamamoto T, Takahashi N, Suzuki Y, Kishida K, Omata S, Ito A, Jingu K. Clinical significance of completion of radium-223 treatment and acute adverse events in patients with metastatic castration-resistant prostate cancer. Asia Ocean J Nucl Med Biol 2023;11:13-22. [PMID: 36619192 PMCID: PMC9803628 DOI: 10.22038/aojnmb.2022.67136.1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 01/10/2023]

Number

Cited by Other Article(s)

De Feo MS, Filippi L, Bauckneht M, Lodi Rizzini E, Ferrari C, Lavelli V, Marongiu A, Sambuceti G, Battisti C, Mura A, Fornarini G, Rebuzzi SE, Farcomeni A, Murabito A, Nuvoli S, Conte M, Montebello M, Costa RP, Golemi A, Mascia M, Travascio L, Monari F, Rubini G, Spanu A, De Vincentis G, Frantellizzi V. Large Italian Multicenter Study on Prognostic Value of Baselines Variables in mCRPC Patients Treated with ²²³RaCl₂: Ten Years of Clinical Experience. Diagnostics (Basel) 2025;15:339. [PMID: 39941269 PMCID: PMC11817225 DOI: 10.3390/diagnostics15030339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Revised: 01/29/2025] [Accepted: 01/30/2025] [Indexed: 02/16/2025] Open

Abstract

Background/Objectives: The prognostic value of baseline clinical parameters in predicting the survival prolonging effect of Radium-223-dichloride (223RaCl2) for metastatic castration resistant prostate cancer (mCRPC) patients has been the object of intensive research and remains an open issue. This national multicenter study aimed to corroborate the evidence of ten years of clinical experience with 223RaCl2 by collecting data from eight Italian Nuclear Medicine Units. Methods: Data from 581 consecutive mCRPC patients treated with 223RaCl2 were retrospectively analyzed. Several baseline variables relevant to the overall survival (OS) analysis were considered, including age, previous radical prostatectomy/radiotherapy, number of previous treatment lines, prior chemotherapy, Gleason score, presence of lymphoadenopaties, number of bone metastases, concomitant use of bisphosphonates/Denosumab, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), as well as baseline values of hemoglobin (Hb), platelets, Total Alkaline Phosphatase (tALP), Lactate Dehydrogenase (LDH), and Prostate-Specific Antigen (PSA). Data were summarized using descriptive statistics, univariate analysis and multivariate analysis with the Cox model. Results: The median OS time was 14 months (95%CI 12-17 months). At univariate analysis age, the number of previous treatment lines, number of bone metastases, ECOG-PS, presence of lymphadenopathies at the time of enrollment, as well as baseline tALP, PSA, and Hb, were independently associated with OS. After multivariate analysis, the number of previous treatment lines (HR = 1.1670, CI = 1.0095-1.3491, p = 0.0368), the prior chemotherapy (HR = 0.6461, CI = 0.4372-0.9549, p = 0.0284), the presence of lymphadenopathies (HR = 1.5083, CI = 1.1210-2.0296, p = 0.0066), the number of bone metastases (HR = 0.6990, CI = 0.5416-0.9020, p = 0.0059), ECOG-PS (HR = 1.3551, CI = 1.1238-1.6339, p = 0.0015), and baseline values of tALP (HR = 1.0008, CI = 1.0003-1.0013, p = 0.0016) and PSA (HR = 1.0004, CI = 1.0002-1.0006, p = 0.0005) remained statistically significant. Conclusions: In the era of precision medicine and in the landscape of novel therapies for mCRPC, the prognostic stratification of patients undergoing 223RaCl2 has a fundamental role for clinical decision-making, ranging from treatment choice to optimal sequencing and potential associations. This large Italian multicenter study corroborated the prognostic value of several variables, emerging from ten years of clinical experience with 223RaCl2.

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Affiliation(s)

Maria Silvia De Feo Department of Radiological Sciences, Oncology and Anatomo Pathology, Sapienza, University of Rome, 00161 Rome, Italy; (M.S.D.F.); (M.C.); (M.M.); (G.D.V.); (V.F.)
Luca Filippi Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
Matteo Bauckneht Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (M.B.); (G.S.)
Elisa Lodi Rizzini Radiation Oncology, IRCSS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.L.R.); (F.M.)
Cristina Ferrari Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (C.F.); (V.L.); (C.B.); (G.R.)
Valentina Lavelli Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (C.F.); (V.L.); (C.B.); (G.R.)
Andrea Marongiu Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.M.); (A.M.); (S.N.); (A.S.)
Gianmario Sambuceti Department of Health Sciences (DISSAL), University of Genova, 16132 Genova, Italy; (M.B.); (G.S.)
Claudia Battisti Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (C.F.); (V.L.); (C.B.); (G.R.)
Antonio Mura Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.M.); (A.M.); (S.N.); (A.S.)
Giuseppe Fornarini Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
Sara Elena Rebuzzi Medical Oncology Unit, Ospedale San Paolo, 17100 Savona, Italy;
Alessio Farcomeni Department of Economics & Finance, University of Rome “Tor Vergata”, 00133 Rome, Italy;
Alessandra Murabito Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (A.M.); (R.P.C.)
Susanna Nuvoli Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.M.); (A.M.); (S.N.); (A.S.)
Miriam Conte Department of Radiological Sciences, Oncology and Anatomo Pathology, Sapienza, University of Rome, 00161 Rome, Italy; (M.S.D.F.); (M.C.); (M.M.); (G.D.V.); (V.F.)
Melissa Montebello Department of Radiological Sciences, Oncology and Anatomo Pathology, Sapienza, University of Rome, 00161 Rome, Italy; (M.S.D.F.); (M.C.); (M.M.); (G.D.V.); (V.F.)
Renato Patrizio Costa Unit of Nuclear Medicine, Biomedical Department of Internal and Specialist Medicine, University of Palermo, 90133 Palermo, Italy; (A.M.); (R.P.C.)
Arber Golemi Nuclear Medicine, IRCSS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
Manlio Mascia Radiopharmacy Section, Ospedale G. Mazzini, Piazza Italia, 64100 Teramo, Italy;
Laura Travascio Unit of Nuclear Medicine, Spirito Santo Hospital, 65100 Pescara, Italy;
Fabio Monari Radiation Oncology, IRCSS Azienza Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (E.L.R.); (F.M.)
Giuseppe Rubini Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy; (C.F.); (V.L.); (C.B.); (G.R.)
Angela Spanu Unit of Nuclear Medicine, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.M.); (A.M.); (S.N.); (A.S.)
Giuseppe De Vincentis Department of Radiological Sciences, Oncology and Anatomo Pathology, Sapienza, University of Rome, 00161 Rome, Italy; (M.S.D.F.); (M.C.); (M.M.); (G.D.V.); (V.F.)
Viviana Frantellizzi Department of Radiological Sciences, Oncology and Anatomo Pathology, Sapienza, University of Rome, 00161 Rome, Italy; (M.S.D.F.); (M.C.); (M.M.); (G.D.V.); (V.F.)

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Fukai S, Daisaki H, Umeda T, Shimada N, Terauchi T, Koizumi M. Evaluation of two-dimensional total bone uptake (2D-TBU) and bone scan index (BSI) extracted from active bone metastatic burden on the bone scintigraphy in patients with radium-223 treatment. Ann Nucl Med 2024;38:450-459. [PMID: 38517659 DOI: 10.1007/s12149-024-01918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/25/2024] [Indexed: 03/24/2024]

Abstract

OBJECTIVE

Radium-223 is a first alpha-emitting radionuclide treatment for metastatic castration-resistant prostate cancer (mCRPC) patients with bone metastases. Although the spread-based bone scan index (BSI) and novel index of the intensity-based two-dimensional total bone uptake (2D-TBU) from bone scintigraphy may provide useful input in radium-223 treatment, they have not been evaluated in detail yet. This study aimed to fill this gap by evaluating BSI and 2D-TBU in patients treated with radium-223.

METHODS

Twenty-seven Japanese patients with mCRPC treated with radium-223 were retrospectively analyzed. The patients were evaluated via blood tests and bone scans at baseline and 3 cycles intervals of treatment. BSI and 2D-TBU were analyzed via VSBONE BSI in terms of correlations, response to radium-223 treatment, association with treatment completion, and the Kaplan-Meier survival analysis was performed.

RESULTS

Nineteen patients (70.4%) completed six cycles of radium-223 treatment, whereas eight patients (29.6%) did not complete the treatment regimen. A significant difference in baseline BSI and 2D-TBU was observed between these groups of patients. Both BSI and 2D-TBU were highly correlated (r = 0.96, p < 0.001). Univariate analysis showed an association between radium-223 completion in median BSI and 2D-TBU values (p = 0.015) and completion percentage differences (91.7% vs. 45.5%; p = 0.027). The Kaplan-Meier product limit estimator showed that the median overall survival was 25.2 months (95% CI 14.0-33.6 months) in the completion group and 7.5 months (95% CI 3.3-14.2 months) in the without completion group (p < 0.001). The overall survival based on median cutoff levels showed a significant difference in 2D-TBU (p = 0.007), but not in BSI (p = 0.15).

CONCLUSIONS

The 2D-TBU may offer advantages over BSI in classifying patients towards radium-223 treatment based on the degree of progression of bone metastases. This study supports the importance of preliminary assessment of bone metastasis status using BSI and 2D-TBU extracted from VSBONE BSI for radium-223 treatment decisions.

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