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dc.contributor.authorVogelzang, NJ
dc.contributor.authorColeman, RE
dc.contributor.authorMichalski, JM
dc.contributor.authorNilsson, S
dc.contributor.authorO'Sullivan, JM
dc.contributor.authorParker, C
dc.contributor.authorWidmark, A
dc.contributor.authorThuresson, M
dc.contributor.authorXu, L
dc.contributor.authorGermino, J
dc.contributor.authorSartor, O
dc.date.accessioned2017-07-05T09:32:43Z
dc.date.issued2017-02
dc.identifier.citationClinical genitourinary cancer, 2017, 15 (1), pp. 42 - 52.e8
dc.identifier.issn1558-7673
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/670
dc.identifier.eissn1938-0682
dc.identifier.doi10.1016/j.clgc.2016.07.027
dc.description.abstractBackground Myelosuppression is common in patients with progressive castration-resistant prostate cancer and bone metastases. Radium-223 prolongs overall survival in these patients but may cause myelosuppression; understanding risk factors will improve clinical decision making. We describe hematologic safety of radium-223 in ALSYMPCA and post hoc analyses identifying patients at increased risk for hematologic toxicity.Patients and methods Hematologic parameters and adverse events were analyzed. Multivariate analyses assessing baseline risk factors for hematologic toxicities were performed separately for radium-223 and placebo patients.Results Nine hundred one patients received radium-223 (n = 600) or placebo (n = 301); 65% of radium-223 and 48% of placebo patients had the full 6 cycles. Grade 3/4 thrombocytopenia was more common in radium-223 versus placebo patients (6% vs. 2%). Logistic regression analyses identified significant baseline predictors for grade 2-4 hematologic toxicities related to radium-223 treatment: extent of disease (6-20 vs. < 6 bone metastases; odds ratio [OR] = 2.76; P = .022) and elevated prostate-specific antigen (OR = 1.65; P = .006) for anemia; prior docetaxel (OR = 2.16; P = .035), decreased hemoglobin (OR = 1.35; P = .008), and decreased platelets (OR = 1.44; P = .030) for thrombocytopenia. Neutropenia events were too few in placebo patients for a comparative analysis. There were no significant associations between hematologic toxicities and number of radium-223 injections received (4-6 vs. 1-3).Conclusion Radium-223 has a favorable safety profile with a low myelosuppression incidence. Understanding baseline factors associated with myelosuppression may assist clinicians in avoiding severe myelosuppression events with radium-223.
dc.formatPrint-Electronic
dc.format.extent42 - 52.e8
dc.languageeng
dc.language.isoeng
dc.relation.replacesinternal/429
dc.relation.replaceshttps://repository.icr.ac.uk/handle/internal/429
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.subjectHumans
dc.subjectBone Neoplasms
dc.subjectThrombocytopenia
dc.subjectNeutropenia
dc.subjectRadium
dc.subjectRadioisotopes
dc.subjectAntineoplastic Agents
dc.subjectPrognosis
dc.subjectIncidence
dc.subjectRisk Factors
dc.subjectDouble-Blind Method
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectProstatic Neoplasms, Castration-Resistant
dc.titleHematologic Safety of Radium-223 Dichloride: Baseline Prognostic Factors Associated With Myelosuppression in the ALSYMPCA Trial.
dc.typeJournal Article
dcterms.dateAccepted2016-07-30
rioxxterms.versionofrecord10.1016/j.clgc.2016.07.027
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
rioxxterms.licenseref.startdate2017-02
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfClinical genitourinary cancer
pubs.issue1
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume15
pubs.embargo.termsNot known
dc.contributor.icrauthorParker, Chrisen
dc.contributor.icrauthorMarsden,en


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