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dc.contributor.authorParker, C
dc.contributor.authorTunariu, N
dc.contributor.authorTovey, H
dc.contributor.authorAlonzi, R
dc.contributor.authorBlackledge, MD
dc.contributor.authorCook, GJR
dc.contributor.authorChua, S
dc.contributor.authorDu, Y
dc.contributor.authorHafeez, S
dc.contributor.authorMurray, I
dc.contributor.authorPadhani, AR
dc.contributor.authorStaffurth, J
dc.contributor.authorTree, A
dc.contributor.authorStidwill, H
dc.contributor.authorFinch, J
dc.contributor.authorCurcean, A
dc.contributor.authorChatfield, P
dc.contributor.authorPerry, S
dc.contributor.authorKoh, D-M
dc.contributor.authorHall, E
dc.identifier.citationJNCI Cancer Spectrum, 2023, pp. pkad077 -
dc.description.abstractBACKGROUND: Radium-223 is a bone-seeking, ɑ-emitting radionuclide used to treat men with bone metastases from castration-resistant prostate cancer. Sclerotic bone lesions cannot be evaluated using Response Evaluation Criteria in Solid Tumors. Therefore, imaging response biomarkers are needed. METHODS: We conducted a phase 2 randomized trial to assess disease response to radium-223. Men with metastatic castration-resistant prostate cancer and bone metastases were randomly allocated to 55 or 88 kBq/kg radium-223 every 4 weeks for 6 cycles. Whole-body diffusion-weighted magnetic resonance imaging (DWI) was performed at baseline, at cycles 2 and 4, and after treatment. The primary endpoint was defined as a 30% increase in global median apparent diffusion coefficient. RESULTS: Disease response on DWI was seen in 14 of 36 evaluable patients (39%; 95% confidence interval = 23% to 56%), with marked interpatient and intrapatient heterogeneity of response. There was an association between prostate-specific antigen response and MRI response (odds ratio = 18.5, 95% confidence interval = 1.32 to 258, P = .013). Mean administered activity of radium-223 per cycle was not associated with global MRI response (P = .216) but was associated with DWI response using a 5-target-lesion evaluation (P = .007). In 26 of 36 (72%) patients, new bone metastases, not present at baseline, were seen on DWI scans during radium-223 treatment. CONCLUSIONS: DWI is useful for assessment of disease response in bone. Response to radium-223 is heterogeneous, both between patients and between different metastases in the same patient. New bone metastases appear during radium-223 treatment.The REASURE trial is registered under ISRCTN17805587.
dc.format.extentpkad077 -
dc.publisherOxford University Press (OUP)
dc.relation.ispartofJNCI Cancer Spectrum
dc.titleRadium-223 in metastatic castration-resistant prostate cancer: whole-body diffusion-weighted magnetic resonance imaging scanning to assess response.
dc.typeJournal Article
rioxxterms.typeJournal Article/Review
pubs.organisational-groupICR/Primary Group
pubs.organisational-groupICR/Primary Group/ICR Divisions
pubs.organisational-groupICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-groupICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-groupICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-groupICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-groupICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished online
icr.researchteamClinic Acad RT Huddart
icr.researchteamClin Trials & Stats Unit
dc.contributor.icrauthorHafeez, Shaista
dc.contributor.icrauthorHall, Emma
icr.provenanceDeposited by Mrs Jessica Perry (impersonating Prof Emma Hall) on 2023-11-14. Deposit type is initial. No. of files: 1. Files: Radium-223 in metastatic castration-resistant prostate cancer.pdf

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