Radium-223’s Impact on Skeletal Events in Metastatic Castration-Resistant Prostate Cancer: A Meta-Analysis

1Huang Ya-Ting, 1Chen Li-Yu, 2Chang Yen-Hsiang.

1 Primo Biotechnology Co., Ltd , Taipei, Taiwan.
2Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
This study poster was presented at 2025 65th Annual Meeting of the Japanese Society of Nuclear Medicine (JSNM).

Purpose: To evaluate the clinical benefit of Radium-223 (Ra-223) in delaying symptomatic skeletal events (SSEs) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Procedure: A systematic search was conducted in PubMed and Cochrane Library to identify studies on Ra-223 in mCRPC patients with bone metastases up to March 10, 2023. The pooled incidence and time to first SSE were analyzed using random-effects meta-analysis.

Result: A total of 37 studies with 8,103 patients were included. The pooled incidence of SSEs was 19% (95% CI: 15 -25%). Median time to first SSE was 17.14 months (95% CI: 11.98 -23.02). Ra-223 significantly delayed SSE onset compared to placebo. Combination therapy further extended the time to first SSE.

Conclusion: Ra-223 effectively delays SSEs in mCRPC, especially in combination regimens, supporting its clinical utility.