Break out.

A clear limit to a quality of life bolster from radium-223 is that it itself can cause bone fracture. To quantify this risk further, post-hoc secondary analysis was performed on the prospective phase 2 REASURE trial of 36 men receiving up to six cycles of radium-223 q4 weeks for castration-resistant prostate cancer metastatic to bone. The primary aim was to compare fracture risk in this prospective cohort to a matched retrospective cohort of 36 men not receiving radium-223. At a median follow-up of 16 months, 74 new fractures were identified in 20 (56%) men receiving radium-223 versus 16 new fractures in 12 (33%) men not receiving it. The authors practically conclude that probably all men with prostate cancer metastatic to bone, but especially those receiving radium-223, should consider the utility of bisphosphonates. | Hijab, Clin Genitourin Cancer 2021