Dr. Tanya Dorff (City of Hope Comprehensive Cancer Center, Los Angeles, USA) and Dr. Phillip Koo (Banner MD Anderson Cancer Center, Arizona, USA) discuss the latest developments in the field of radiopharmaceuticals and their use in Prostate Cancer. They are also joined by guest speaker Dr. Neal Shore (Carolina Urologic Research Center, North Carolina, USA). In this first episode, the experts focus on the alpha emitter, Radium-223 which received regulatory approval on the basis of the phase 3 ALSYMPCA trial in patients with metastatic castration resistant prostate cancer (mCRPC) and symptomatic bone metastases. They consider mechanism of action and discuss key results from the trial and the safety profile. The experts also review the ERA-223 and PEACE-III randomised trials which investigated the use of Radium-223 in combination with next generation androgen receptor inhibitors (ARIs). A number of real-world evidence studies are also reviewed as the experts consider where radium-223 fits into the overall treatment sequence for mCRPC patients. Radiation safety and general considerations for delivering therapy with radiopharmaceuticals are also discussed.

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