Alpharadin shows 2.8-month survival benefit in mCRPC

The investigational radioisotope radium-233 chloride (Alpharadin) has shown a small but clinically significant overall survival benefit in the treatment of men with symptomatic, metastatic, castration-resistant prostate cancer (mCRPC).

According to a media release this morning from Algeta ASA and a report in the Wall Street Journal this morning, “The median overall survival rate was 14 months for Alpharadin users, compared with 11.2 months for those on the placebo.” We should point out immediately that these data are not being presented at the current annual meeting of the American Society for Clinical Oncology. We are going to have to wait to see more detailed data.

The rumor going around at ASCO this morning was that the trial had shown an astonishing 14-month survival benefit compared to placebo. Clearly this is not, in fact, these case.

Alpharadin has been licensed to Bayer Schering Pharma AG (“Bayer”) by the Norwegian company Algeta.

The ALSYMPCA study (ALpharadin in SYMptomatic Prostate CAncer patients) is an international, double-blind, randomized, placebo-controlled phase III clinical trial deigned to evaluate the potential of Alpharadin plus best standard of care  versus placebo plus best standard of care to treat symptomatic bone metastases in CRPC patients. The trial began in June 2008, enrollment in the trial was completed in January 2011 and 922 patients were randomized.

According to the media release from Algeta, Dr Chris Parker, from the Royal Marsden Hospital in Sutton, England, who is the principal investigator for the ALSYMPCA trial, “Around 90 percent of men with advanced prostate cancer have bone metastases, which are the main cause of disability and death in this disease.  Advanced prostate cancer has a poor prognosis, and treatment options are limited. Based on the observed survival benefit and its safety profile, Alpharadin may become an important treatment for patients with bone metastases from advanced prostate cancer.”

This result makes Alpharadin the fourth new drug to show effectiveness in extending the survival of men with mCRPC in just the past 2 years — a degree of progress in the treatment of mCRPC that would have seemed almost unimaginable just 5 years ago.

3 Responses

  1. So can we add all these drugs up and get an overall cumulative survival benefit?

  2. This is very good news, as we can all agree. Radio-pharmaceuticals had previously been used to reduce symptoms and not for overall survival. Thus survival benefit is meaningful and I think repeated applications of Alpharadin could also occur in at least some patients. Radium releases significant energy over a very limited distance, which contrasts with samarium (Quadramet):

    — Samarium (Quadramet): 0.22 MeV; penetration 0.55 mm

    — Radium (Alpharadin): 5.78 MeV; penetration 0.01 mm

    Higher energy and less penetration are the goals. Nuclear medicine specialists are encouraged to post corrections to my high school physics understanding.

  3. No … Unfortunately we can’t. We don’t, for example, know that someone who gets an extra 3.9 (or 4.6) months of survival benefit from use of abiraterone will still get an additional 2.8 months of survival benefit from the use of radium-223. It is going to take additional studies to resolve questions like that.

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