Trial reportCancer immunology research2024
Randomized Phase II Study Evaluating the Addition of Pembrolizumab to Radium-223 in Metastatic Castration-resistant Prostate Cancer.
Trial report in Cancer immunology research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Comparison of complications and oncology outcomes of immunotherapy alone and combination in metastatic castration-resistant prostate cancer (mCRPC): a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Pooled it
- Novel Therapeutic Strategies for Metastatic Prostate Cancer Care.European urology · 2025Pooled it
- Combinations of treatments based on radiotherapy or radionuclides to enhance immunotherapy efficacy in advanced prostate cancer: a systematic review.Journal of cancer research and clinical oncology · 2025Pooled it
- A Phase II Study of Berzosertib in Combination with Carboplatin Compared with Docetaxel with Carboplatin in Metastatic Castration-Resistant Prostate Cancer.Cancer research communications · 2026Trial
- Trial
- Current landscape and emerging trends of PD-1/PD-L1 research in prostate cancer: A data-driven atlas from multidatabase integration.Human vaccines & immunotherapeutics · 2026Article
- Radium-223 decreases PD-L1 expression in bone metastases: A study with [European journal of nuclear medicine and molecular imaging · 2026Article
- Radium - from discovery to the present day - narrative review.Clinical and experimental medicine · 2026Review
- Activation of tumor-specific CD8+ T cells prior to radiopharmaceutical therapy improves antitumor response.Journal for immunotherapy of cancer · 2026Article
- Emerging role of radiopharmaceutical therapy in oncology: advances, challenges, and future directions.JNCI cancer spectrum · 2026Review
- Multi-modal circulating cell-free DNA profiling to predict response to docetaxel in metastatic castration-resistant prostate cancer.NPJ precision oncology · 2026Article
- Preclinical Evaluation of Radium-223 and Immune Checkpoint Inhibitors Using an Immune-Competent Model of Prostate Cancer Bone Metastases.Precision oncology · 2026Article
- Real-World Outcomes of Combination Therapy With Radium-223 and Enzalutamide Compared With Enzalutamide Alone in Patients With Metastatic Castration-Resistant Prostate Cancer.Advances in urology · 2026Article
- Influence of immune checkpoint inhibitor target and timing on combination treatment with antibody-based β-emitting targeted radionuclide therapy across tumor immunogenicity profiles.Frontiers in immunology · 2026Article
- Targeted alpha therapy: a comprehensive analysis of the biological effects from "local-regional-systemic" dimensions.European journal of nuclear medicine and molecular imaging · 2025Review
- Redefining Prostate Cancer Precision: Radiogenomics, Theragnostics, and AI-Driven Biomarkers.Cancers · 2025Review
- Optimizing Radiation Therapy for Localized Prostate Cancer: Exploring Synergies With Androgen Deprivation Therapy and Novel Systemic Agents.Seminars in radiation oncology · 2025Review
- Immune Checkpoint Inhibitor Therapy for Prostate Cancer: Present and Future Prospectives.Biomolecules · 2025Review
- Precision Targeting in Metastatic Prostate Cancer: Molecular Insights to Therapeutic Frontiers.Biomolecules · 2025Review
- DirectHRD enables sensitive scar-based classification of homologous recombination deficiency.Nucleic acids research · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 8 institutions in 3 countries.
Funding
Abstract
The checkpoint immunotherapeutic pembrolizumab induces responses in a small minority of patients with metastatic castration-resistant prostate cancer (mCRPC). Radium-223 (R223) may increase immunogenicity of bone metastases and increase pembrolizumab (P) activity. In a randomized phase II study, we assessed the effect of R223+P compared with R223 on tumor immune infiltration, safety, and clinical outcomes in patients with mCRPC. The primary endpoint was differences in CD4+ and CD8+ T-cell infiltrate in 8-week versus baseline bone metastasis biopsies; secondary endpoints were safety, radiographic progression-free survival (rPFS), and overall survival (OS). Of the 42 treated patients (29 R223+P, 13 R223), 18 R223+P and 8 R223 patients had evaluable paired tumor biopsies. Median fold-change of CD4+ T cells was -0.7 (range: -9.3 to 4.7) with R223+P and 0.1 (-11.1 to 3.7) with R223 (P = 0.66); for CD8+ T cells, median fold-change was -0.6 (-7.4 to 5.3) with R223+P and -1.3 (-3.1 to 4.8) with R223 (P = 0.66). Median rPFS and OS was 6.1 (95% confidence interval: 2.7-11.0) and 16.9 months [12.7-not reached (NR)], respectively, with R223+P and 5.7 (2.6-NR) and 16.0 (9.0-NR), respectively, with R223. Although R223+P was well tolerated with no unexpected toxicity, the combination did not improve efficacy. High-dimensional flow cytometry demonstrated minimal immune modulation with R223, whereas R223+P induced CTLA-4 expression on circulating CD4+ T cells. Clinical responders possessed lower circulating frequencies of Ki67+ T and myeloid cells at baseline and higher circulating frequencies of TIM-3+ T and myeloid cells by week 9. Although R223+P did not induce T-cell infiltration into the tumor microenvironment, exhaustion of induced peripheral T-cell immune responses may dampen the combination's clinical activity.
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Registered trials
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.