Evidence map›Paper›PMID 36156455›Full record

ArticleCancer medicine2023

Radium-223 dichloride treatment in metastatic castration-resistant prostate cancer in Finland: A real-world evidence multicenter study.

Anniina Hyväkkä, Okko-Sakari Kääriäinen, Tapio Utriainen, Eliisa Löyttyniemi, Kalle Mattila, Petri Reinikainen, Jorma Sormunen, Minna Jääskeläinen, Päivi Auvinen, Heikki Minn and 1 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 20 citations in OpenAlex.

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  7. Exploring the Therapeutic Potential ofInternational journal of molecular sciences · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Anniina HyväkkäCancer Research Unit, Institute of Biomedicine, and Department of Oncology, FICAN West Cancer Center, University of Turku, Turku University Hospital, Turku, Finland.ORCID 0000-0002-0732-2788
Okko-Sakari KääriäinenDepartment of Oncology, Kuopio University Hospital, Kuopio, Finland.
Tapio UtriainenHelsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland.
Eliisa LöyttyniemiDepartment of Biostatistics, Institute of Clinical Medicine, University of Turku, Turku, Finland.
Kalle MattilaDepartment of Oncology and FICAN West Cancer Center, University of Turku, Turku University Hospital, Turku, Finland.
Petri ReinikainenDepartment of Oncology, Tampere University Hospital, Tampere, Finland.
Jorma SormunenDepartment of Oncology, Tampere University Hospital, Tampere, Finland.
Minna JääskeläinenDepartment of Oncology, Oulu University Hospital, Oulu, Finland.
Päivi AuvinenDepartment of Oncology, Kuopio University Hospital, Kuopio, Finland.
Heikki MinnDepartment of Oncology and FICAN West Cancer Center, University of Turku, Turku University Hospital, Turku, Finland.ORCID 0000-0002-5878-4333
Maria SundvallCancer Research Unit, Institute of Biomedicine, and Department of Oncology, FICAN West Cancer Center, University of Turku, Turku University Hospital, Turku, Finland.ORCID 0000-0002-0494-2965
University of Turku · FIKuopio University Hospital · FITampere University Hospital · FIHelsinki University Hospital · FIOulu University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadium-233 dichloride is an alpha emitter that specifically targets bone metastases in prostate cancer. Results of a previously reported phase III randomized trial showed survival benefit for radium-223 compared to best supportive care in castration-resistant prostate cancer (CRPC) with bone metastases. However, real-world data are also needed with wider inclusion criteria.

methodsWe report results of a retrospective multicenter study including all patients with metastatic CRPC treated with radium-223 in all five university hospitals in Finland since the introduction of the treatment. We identified 160 patients who had received radium-223 in Finland in 2014-2019.

resultsThe median overall survival (OS) was 13.8 months (range 0.5-57 months), and the median real-world progression-free survival (rwPFS) was 4.9 months (range 0.5-29.8 months). Alkaline phosphatase (ALP) values within the normal range before and during the radium-223 treatment or the reduction of elevated ALP to normal range during treatment were associated with better OS when compared to elevated ALP values before and during treatment (p < 0.0001). High prostate-specific antigen (PSA) level (≥100 μg/L) before radium-223 treatment was associated with poor OS compared to low PSA level (<20 μg/L) (p = 0.0001). Most patients (57%) experienced pain relief. Pain relief indicated better OS (p = 0.002). Radium-223 treatment was well tolerated. Toxicity was mostly low grade. Only 12.5% of the patients had grade III-IV adverse events, most commonly anemia, neutropenia, leucopenia, and thrombocytopenia.

conclusionRadium-223 was well tolerated in routine clinical practice, and most patients achieved pain relief. Pain relief, ALP normalization, lower baseline PSA, and PSA decrease during radium-223 treatment were prognostic for better survival. The efficacy of radium-223 in mCRPC as estimated using OS was comparable to earlier randomized trial in this retrospective real-world study. Our results support using radium-223 for mCRPC patients with symptomatic bone metastases even in the era of new-generation androgen receptor-targeted agents.

Indexed as

NeutropeniaProstatic Neoplasms, Castration-ResistantAlkaline PhosphataseColoring AgentsFinlandHumansMalePainProstate-Specific AntigenRadioisotopesRadiumRetrospective StudiesAlkaline PhosphataseColoring AgentsProstate-Specific AntigenRadioisotopesRadiumRadium-223radium Ra 223 dichloridebone metastasescastration-resistant prostate cancerradium-233 (Ra-223) therapyreal-world evidence

Identifiers

PMID36156455
PMCPMC9972699
OpenAlexW4297222350

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.