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Published on: March 6, 2018
Meaningful Radiographic and Metabolic Response to Enzalutamide Plus Radium-223 Therapy in Metastatic
Yamato Numata1, Go Kimura1, Jun Akatsuka1
1Department of Urology Nippon Medical School Tokyo Japan.
IJU Case Reports
|July 15, 2026
Summary
Enzalutamide combined with radium-223 shows promise for metastatic castration-resistant prostate cancer, even with discordant PSA progression. This combination therapy improved skeletal disease and bone turnover markers in a real-world case.
Area of Science:
- Oncology
- Radiopharmaceuticals
- Prostate Cancer Research
Background:
- Metastatic castration-resistant prostate cancer (mCRPC) treatment is challenging.
- Limited real-world data exists for combined enzalutamide and radium-223, especially in PSA-discordant progression.
- PSA-discordant progression presents unique therapeutic challenges.
Purpose of the Study:
- To evaluate the clinical benefit of combined enzalutamide and radium-223 in mCRPC with PSA-discordant progression.
- To present a case study illustrating the efficacy of this combination therapy.
Main Methods:
- A 74-year-old male patient with high-risk localized prostate cancer received ADT and radiotherapy.
- Disease progression with extensive metastases and low PSA (PSA-discordant progression) was observed.
- Combination therapy with enzalutamide and six cycles of radium-223 was administered.
Main Results:
- Significant improvement in skeletal disease activity and bone turnover markers was noted post-treatment.
- The patient experienced grade 3 anemia requiring transfusion as the main adverse event.
- No other severe adverse events were reported.
Conclusions:
- Enzalutamide and radium-223 combination therapy may offer clinical benefit in mCRPC with PSA-discordant progression.
- This case highlights the potential of combined therapy in managing challenging mCRPC cases.
- Further real-world studies are warranted to confirm these findings.
