Introduction
Radium-223 dichloride (trade name: Xofigo) was approved in November 2013 for the treatment of prostate cancer that has spread to the bones (bone metastases) in men for whom a standard hormone blocker is no longer effective. In September 2018, the approval status was changed. Since then, radium-223 dichloride is only an option for men who have prostate cancer that is progressing despite two previous systemic treatments or for whom systemic treatment is no longer possible.
If prostate cancer is at an advanced stage, the tumor has spread to other parts of the body and complete recovery is no longer possible. Then systemic treatment is used. This means that the treatment has an effect on the whole body. Using medication to block the production of testosterone is one way to slow down the progression of the cancer. If the cancer progresses despite treatment with these hormone blockers, it is referred to as "hormone refractory" or "castration-resistant" metastatic prostate cancer. Other treatments are then often used as well, such as chemotherapy.
Radium-223 dichloride has been approved for use in patients who have bone metastases that are causing symptoms, such as pain.
Radium-223 dichloride is radioactive and collects mostly in the bones. When applied from a nearby source, it is supposed to slow the growth of the bone metastases. If there are metastatic tumors in other organs as well, it shouldn't be used.
