The Challenge of Bone-Metastatic PC

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Presentation transcript:

Understanding the Mechanism of Radionuclides and Survival in Bone Mets in CRPC

The Challenge of Bone-Metastatic PC

PC: Unique Pattern of Metastasis

Biology of Bone Mets in PC

Tumor Cells Compete With Stem Cells in PC

"Vicious Cycle" of PC Bone Mets

Bone Mets in PC: Predisposing Factors

Consequences of Bony Metastatic Disease

FDA-Approved Bone-Targeted Treatments

"The Land of No Indication"

Approved Uses of Bone-Targeted Therapies

Dosing Zoledronic Acid and Denosumab in PC

Do Zoledronic Acid and Denosumab Add Value in the Modern Treatment Era?

Docetaxel  ZA: SRE-Free Interval

Enzalutamide Post-Docetaxel: Time to SRE

Enzalutamide Increases Fracture Rates

Abiraterone  Prednisone Postdocetaxel: Fractures (COU-AA-301)

Advanced PC: Heterogeneous Group of Diseases

Preferential Uptake of Radium-223 in Osteoblastic Lesions

ALSYMPCA Trial of Radium-223: Survival

ALSYMPCA Trial of Radium-223: Time to SSEs

ALSYMPCA Trial: Effects of Radium-223 on SSEs, Stratified by Bisphosphonate Use

Lessons From ALSYMPCA

Can Radium Add Value to Abiraterone or Enzalutamide in Bone-Metastatic CRPC?

If Concomitant Hormonal Therapy Is Used, When Should Radium-223 Be Added?

Potential to Target PSMA

PSA Decline With PSMA-Targeted Therapy

Case Report: PSMA-Targeted Alpha Emitter (Actinium-225)

The Future of Targeted Radiation in PC

Summary

Abbreviations