OREANDA-NEWS. August 15, 2013. Arizona Oncology, a statewide practice in The US Oncology Network and a leading provider of comprehensive, state-of-the art cancer treatment, is the first provider in Arizona to offer Xofigo-a ground-breaking treatment for advanced prostate cancer.   In clinical trial, patients receiving Xofigo experienced reduced bone pain and prolonged survival compared with patients who received a placebo.

Xofigo (Radium-223 dichloride) was recently approved by the FDA for the treatment of patients with metastatic castration-resistant prostate cancer that has spread to the bones, but no other organs. It is intended for men whose cancer has spread after receiving medical or surgical therapy to lower testosterone.

Arizona patients can now receive the treatment at the Phoenix Biltmore Cancer and Imaging Center and Arrowhead Radiation Oncology and Imaging Center in Glendale with Drs. Jerry Lucas, Kenneth Luk and Irene Taw.  Arizona Oncology's Tucson locations are licensed to treat patients with Xofigo and plan to do their first treatment in the coming weeks.

"Xofigo is administered as an intravenous injection of a solution of Radium-223 once a month for six months," explains Dr. Luk.  His patient is the first in Arizona to receive this treatment after FDA approval.  "It is a radioactive compound which selectively binds with bone at the area of cancer involvement and emits a form of radiation called alpha particles.  These particles can cause more severe damage biologically to cancer cells than conventional therapeutic x-rays.  The high energy particle radiation also does not penetrate too deeply into tissues before it stops, therefore minimizing the toxic effects to nearby healthy cells. The favorable safety profile of this material, plus the relatively short half-life (the time it takes for one half of the radioactivity to dissipate) of 11 days, make it an attractive treatment to offer these patients."

In the clinical trial that led to FDA approval, Xofigo was compared to a placebo infusion in patients with prostate cancer with bone pain secondary to metastatic disease and whose cancers were progressing despite depletion of serum testosterone (castrate resistant prostate cancer, or CRPC). The clinical trial showed that Xofigo had significant activity in reducing bone pain and showed that patients who received Xofigo had prolonged survival compared to patients who received the placebo.

"There have been other radioactive pharmaceuticals that we use for some situations of diffuse bone metastases," says Dr. Luk.   "However, this is the first commercially available alpha particle radiation.  The others emit beta rays which are electrons with less effectiveness in LET (linear energy transfer) and less capability in cell DNA destruction.  There have not been any head-to-head comparisons of these treatment methods in patient treatments to compare efficacy or toxicity."

Xofigo joins a list of multiple new treatments for metastatic castrate resistant prostate cancer that have been approved by the FDA in the last 10 years because Phase III clinical trials with these agents have shown survival benefit versus either placebo or another active therapy. These other treatments include Taxotere (docetaxel) in 2004, Provenge (sipuleucel-T) and Jevtana (cabazitaxel) in 2010, Zytiga (abirateron) in 2011, and Xtandi (enzalutamide) in 2012. All of these therapies are available for patients with castrate-resistant prostate cancer at Arizona Oncology.