Radium-223 and concomitant therapies: prospects and prudence

Most patients with relapsed prostate cancer develop metastatic disease and eventually become castration-resistant. Skeletal metastasis is common in castrate resistant prostate cancer and is an independent poor prognostic factor (1). Furthermore, skeletal related events (SRE) such as spinal cord compression, pathologic fractures and requirement for external beam radiation for pain palliation continue to represent a significant cause of morbidity for patients with bone metastasis (2). Over the last decade, significant strides have been made in the development of therapies for patients with castrate resistant metastatic prostate cancer (CRPC).