Radium-223 and metastatic castration-resistant prostate cancer: All that glitters is not gold

• 作者: Carlo Aprile Federica E Buroni Lorenzo Lodola Marco G Persico
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Radium-223 骨头转移 阉割抵抗前列腺癌症 肿瘤微型环境 Pre 变形的壁龛模型
• 年，卷（期）: 2016,（10）
• 页码范围: 816-818
• 页数: 3页
• 分类号: R737.25

摘要

After being approved by the National Drug Agency in several countries, Radium-223(Ra-223) is gaining wide acceptance in the treatment of bone metastatic castration resistant prostate cancer. The exact mechanism of action remain unclear: The established model of direct alpha-particle irradiation from the remodelling bone surface, where Ra-223 accumulates, surrounding the tumor foci can explain a lethal effect only on metastatic microdeposits, but not on higher tumor burden. According to the 'pre-metastatic niche model', it is likely that Ra-223 targets several non-tumoral cell types of the tumor microenvironment involved in the complex mechanism of cancer bone homing and colonization. A deeper insight into this hypothetical mechanism will lead to a more accurate dosimetric approach and to find optimal sequencing and/or combination with the other therapeutic options.