Re: Current treatment strategies for advanced prostate cancer.

Although the ALSYMPCA study showed prolonged overall survival (OS) of prostate cancer patients, it is often difficult to predict the benefits of radium-223 (Ra-223) during its treatment course because of a delayed response in prostate-specific antigen levels.[[1]] The European Medical Agency announced the restricted use of Ra-223 based on the findings of the ERA223 study, and suggested that Ra-223 be used only as a third-line treatment or when other treatment options were ineligible.[3] The clinical indication of Ra-223 is therefore restricted to the late phase of castration-resistant prostate cancer (CRPC). A total of 36 (60.0%) patients completed six courses, seven (11.7%) completed five courses and 17 (28.3%) completed four or fewer courses of Ra-223. However, a considerable portion of CRPC patients who started Ra-223 therapy in its late phase failed to complete all six courses. [Extracted from the article]