Rana McKay, MD, on real-world data of radium-223 in mCRPC

In this video, Rana R. McKay, MD, FASCO, shares the background and key findings from the study, “Effectiveness and safety of radium-223 in men with metastatic castration-resistant prostate cancer (mCRPC): A systematic literature review of 48 real-world studies.” These data were presented at the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium in San Francisco, California.

McKay is a genitourinary medical oncologist at the University of California, San Diego (UCSD) and a professor of urology and medicine at UCSD School of Medicine.

Video Transcript:

Could you describe the background/rationale for this analysis?

Radium-223 is a radiopharmaceutical that was FDA approved for the treatment of prostate cancer nearly a decade ago. It was approved during an era where we the treatment landscape was very different for metastatic castration-resistant prostate cancer, and also for metastatic hormone-sensitive prostate cancer. There's been a series of additional studies that have been conducted, various retrospective studies [and] prospective studies, smaller studies that have been conducted, real-world studies that have been conducted with radium. What we proposed to do was do a systematic review of all of this data.

What were the key findings?

In our systemic review, we examined 48 real world studies involving over 15,000 men with metastatic castration-resistant prostate cancer who were treated with radium. Our findings highlight that completing 5 cycles or more of radium was associated with a 2 to 5-fold increase in overall survival. We found that earlier use of radium-223 before multiple other lines of therapy was also associated with better outcomes.

We looked at various study populations and observed that most patients were in the age bracket of mid to late 60s, early 70s. About 25% of the patients in these studies had really high burden of disease, with 20 plus bone metastases. Over half of the patients in about 23 different studies had received prior chemotherapy, and half of the patients from about 22 different studies had received a prior ARPI. Additionally, the data is global in nature. There was representation across both North America, Europe, and the globe. These findings, I think, are really important, as radium is a life-prolonging agent, though it was FDA approved at a time where the treatment landscape was very different for advanced prostate cancer treatment. Understanding the evolution of its utilization in the real world and the modern era is really important.

This transcript was AI generated and edited by human editors for clarity.