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Updated: Jul 25, 2025
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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
Published on: March 6, 2018
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Pain Outcomes in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with 223Ra: PARABO, a
Holger Palmedo1, Hojjat Ahmadzadehfar2, Susanne Eschmann3
1Institute of Radiology and Nuclear Medicine Kaiser Passage and PET/CT Centre, Johanniter Hospital, Bonn, Germany; holger.palmedo@gmx.de.
Summary
Radium-223 (²²³Ra) therapy effectively reduced pain in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastases. A higher number of ²²³Ra injections correlated with better pain relief in this real-world study.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiopharmaceuticals
Background:
- Metastatic castration-resistant prostate cancer (mCRPC) with bone metastases significantly impacts patient quality of life due to pain.
- Radium-223 (²²³Ra) is an approved targeted alpha-therapy demonstrating survival benefits in mCRPC patients.
- Previous studies like ALSYMPCA showed ²²³Ra improved survival and quality of life, but real-world pain management data is crucial.
Purpose of the Study:
- To investigate the efficacy of ²²³Ra in managing pain and improving bone pain-related quality of life in mCRPC patients within a clinical practice setting.
- To assess the proportion of patients achieving a clinically meaningful pain response.
- To explore factors influencing pain response, including the number of ²²³Ra injections and disease characteristics.
Main Methods:
- Prospective, observational, noninterventional, single-arm study (PARABO) conducted in German nuclear medicine centers.
- Inclusion of 354 patients with mCRPC and symptomatic bone metastases receiving ²²³Ra therapy.
- Primary endpoint: clinically meaningful pain response defined as ≥2-point improvement in worst-pain score using the Brief Pain Inventory-Short Form.
Main Results:
- 59% of patients with baseline worst-pain score >1 achieved a clinically meaningful pain response.
- Patients receiving 5-6 injections of ²²³Ra showed a higher response rate (67%) compared to those receiving 1-4 injections (43%).
- Improvements were observed in both pain severity and pain interference subscale scores; metastatic burden did not significantly affect pain response.
Conclusions:
- ²²³Ra therapy demonstrates effectiveness in reducing pain and improving quality of life for mCRPC patients with bone metastases.
- Optimal pain relief appears associated with completing the full course of 5-6 ²²³Ra injections.
- Real-world data supports the role of ²²³Ra in managing symptomatic bone metastases in mCRPC.
