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Prior to the approval of docetaxel for advanced prostate cancer, the available beta-emitting radiopharmaceuticals strontium 89 and samarium were used to provide symptomatic benefit. Although these agents conferred some clinical benefit, they were associated with moderate-to-significant myelosuppresion. Radium-223 is an alpha-emitting, bone-seeking, calcium mimetic that binds into newly formed bone stroma. Such alpha-particle radiation induces potent double-stranded DNA breaks, yet the short path of these particles appears to spare surrounding marrow.
Now, international investigators have conducted an industry-sponsored, phase III trial in which 921 patients with castration-resistant, metastatic prostate cancer were randomized 2:1 to receive …