Purpose of review: Randomized clinical trials of palliative radiation therapy and radiopharmaceuticals are emphasized, and new concepts in targeted alpha-emitter therapy are introduced.
Recent findings: Radiation therapy has a proven palliative role in the treatment of patients with advanced prostate cancer. Findings from 223radium clinical trials emphasize the importance of alpha particles as a new therapeutic modality in patients with bone metastatic castrate-resistant prostate cancer. We introduce the concept of alpha-emitting particles from both a basic and clinical perspective in the realm of bone-targeted radiopharmaceuticals and discuss how these agents compare and contrast with conventional beta-emitting radioisotopes. The physics, radiobiology, and survival data with 223radium are unique compared with previously used radiopharmaceuticals.
Summary: Targeted alpha-emitting therapies such as 223radium have the capacity to change the way we treat patients with bone-metastatic prostate cancer.