Xofigo prostate cancer8/24/2023 There are no crossover side effects when the two are put together. These combination therapies make a lot of sense. If you look at the data from the University of Texas MD Anderson Cancer Center’s series that was published, it showed that use of Zytiga resulted in an improved benefit with the addition of Xofigo. If you can hit the bone disease using Xofigo and hit soft-tissue disease with drugs like Zytiga (abiraterone) or Xtandi (enzalutamide) simultaneously, you will get a great effect. It doesn’t target visceral disease, it doesn’t target nodal disease, and it has no known effect to the soft tissues. ALSYMPCA data have shown that Xofigo can be given safely before or after chemotherapy.To me, this makes a lot of sense because Xofigo is very specific for bone. This is because it’s an alpha emitter and it actually improves overall survival. I think that is the biggest problem it is still being put in that same type of class when it really it doesn’t belong there. In clinical practice, those aren’t used very often because they do cause significant bone marrow suppression, which prevents oncologists from having the option of giving chemotherapy afterwards, if needed.ĭo you think there is potential for Xofigo to be used in combination with other agents? There are data showing that patients who have lower burden bone disease do better with Xofigo, compared with patients who are treated at the end stage of disease.I think there is this association of Xofigo as a radiopharmaceutical in the past, such as samarium 153 lexidronam. That becomes a lot easier if they are treated earlier in their disease. Oncologists need to figure out a way to get them all six doses, if possible. The message is that patients need to get all six doses. ![]() Because of those reasons, Xofigo is really making a big impact.I think the biggest challenge is that oncologists still see it as a palliative tool. You are actually hitting the disease harder and you are not hitting healthy cells as much, so the complication rates are decreased. The beauty of an alpha emitter is that it packs a more powerful punch, so it travels a shorter distance. ![]() It is also the first alpha emitter that has been approved. There are also secondary benefits, including delaying time to first skeletal-related event. Why do you think that many oncologists still view it as only a palliative treatment? That has never been done with radiopharmaceuticals in the past. When it comes to unsealed sources of radiation, this is the first one that has shown an OS benefit. In an interview with CURE at the 26th International Prostate Cancer Update (IPCU) meeting held January 20-23, 2016, in Denver, Colorado, Koo discussed the benefits of Xofigo and why he thinks it is time the use of the drug becomes more widespread for the treatment of mCRPC, and potentially other cancers.Xofigo is a game-changing therapeutic radiopharmaceutical. ![]() “Yes, there are patients who will get pain relief, but the primary endpoint of the ALSYMPCA trial was overall survival, and that is what makes this drug significant.”ĬURE: What do you envision for the role of Xofigo? “Oncologists need to acknowledge the fact that this radiopharmaceutical improves survival,” says Koo, a radiologist of Memorial Hospital and University of Colorado Hospital. The radiopharmaceutical Xofigo (radium-223 dichloride) has demonstrated a median overall survival (OS) benefit of nearly three months compared with placebo for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC).ĭespite the fact that it has been three years since this data from the pivotal ALSYMPCA trial was released and the drug was approved by the FDA, many oncologists still need to be educated regarding Xofigo's benefits beyond pain palliation, says Phillip J.
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