TY - JOUR
T1 - A Case of Success
T2 - Complete Response to Radium-223 in Metastatic Castration-Resistant Prostate Cancer
AU - Soares de Pinho, Inês
AU - Esperança-Martins, Miguel
AU - Machado, Bárbara
AU - Dâmaso, Sara
AU - Lopes Brás, Raquel
AU - Cantinho, Guilhermina
AU - Fernandes, Isabel
AU - Costa, Luís
PY - 2024/2
Y1 - 2024/2
N2 - Radium-223 dichloride (Ra223) is the first targeted alpha agent approved for treating metastatic castration-resistant prostate cancer (mCRPC) with bone-exclusive disease. A benefit in overall survival and time to the first symptomatic skeletal-related event was shown in the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial. However, this trial did not describe a bone scan response to Ra223, and there is no universal consensus about how it should be monitored. Furthermore, a scintigraphy flare phenomenon may lead to false-positive tracer uptake in responsive cases, thereby misleading the interpretation of imaging results. We present the case of a 67-year-old male with mCRPC and exclusive bone disease treated with Ra223. The bone scintigraphy after the end of the treatment showed an apparent aggravation of the lesions, corresponding to a flare phenomenon, with an almost complete resolution after three months. The patient maintained a scintigraphic response for seven months.
AB - Radium-223 dichloride (Ra223) is the first targeted alpha agent approved for treating metastatic castration-resistant prostate cancer (mCRPC) with bone-exclusive disease. A benefit in overall survival and time to the first symptomatic skeletal-related event was shown in the Alpharadin in Symptomatic Prostate Cancer Patients (ALSYMPCA) trial. However, this trial did not describe a bone scan response to Ra223, and there is no universal consensus about how it should be monitored. Furthermore, a scintigraphy flare phenomenon may lead to false-positive tracer uptake in responsive cases, thereby misleading the interpretation of imaging results. We present the case of a 67-year-old male with mCRPC and exclusive bone disease treated with Ra223. The bone scintigraphy after the end of the treatment showed an apparent aggravation of the lesions, corresponding to a flare phenomenon, with an almost complete resolution after three months. The patient maintained a scintigraphic response for seven months.
KW - bone disease
KW - response
KW - flare
KW - radium-223
KW - prostate cancer
U2 - 10.7759/cureus.53637
DO - 10.7759/cureus.53637
M3 - Article
C2 - 38449973
SN - 2168-8184
VL - 16
SP - e53637
JO - Cureus
JF - Cureus
IS - 2
ER -