Dr. Antonarakis on the Utility of Sipuleucel-T Plus Radium-223 in Nonmetastatic CRPC

Emmanuel S. Antonarakis, MBBCh, professor of oncology, Johns Hopkins Medicine, discusses the utility of sipuleucel-T (Provenge) plus radium-223 (Xofigo) in nonmetastatic castration-resistant prostate cancer (CRPC).

Radium-223 is a bone-targeting radiopharmaceutical that emits an alpha particle, says Antonarakis.

As such, it is not likely to have efficacy in patients with nonmetastatic CRPC or rising prostate-specific antigen who do not have bone metastases, explains Antonarakis.

Sipuleucel-T is currently approved in metastatic CRPC. It is unknown whether sipuleucel-T and radium-223 can prevent bone metastases in patients with nonmetastatic CRPC. However, without a target, a drug like radium-223 may not be effective, concludes Antonarakis.