Radium 223 Dichloride

radium 223 dichloride 2d
Brand name: Xofigo®
IUPAC: dichloro(²²³Ra)radium
FDA approval: Yes
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Usage:

Xofigo (radium-223 dichloride) is used to treat certain men with advanced prostate cancer. It is intended for men whose cancer has spread (metastasized) only to their bones and who have already received treatment to lower testosteroneTestosterone is the main male sex hormone and is responsible for the generation of the secondary sex characteristics. The hormone is produced in male testes and is normally found to a much lesser extent in females.. Because testosterone can cause prostate cancer to grow, the goal of some surgery and drug treatments is to lower the level of this male hormoneA chemical produced by cells that alters the activity of other cells. The chemicals may be lipids, such as testosterone and estrogen or proteins like insulin. Hormones may act at locations far from their site of origin. Estrogen, for example, is produced primarily by cells in the ovaries but acts on cells in the breast and elsewhere. in the body. When the cancer spreads or comes back after such treatment, it’s sometimes called castration-resistant. Xofigo is a type of radiopharmaceutical. Radiopharmaceuticals are radioactiveSome elements (atoms) are not stable. The breakdown of these elements leads to the release of energy that is called radiation. The form of the energy (radiation) may differ between different unstable elements. Radiation from the breakdown of radioactive elements is damaging to cells and their genes. Cancer cells do not respond in a normal fashion to DNA damage and may be sensitive to killing by the radiation emitted from radioactive elements. drugs. Radiopharmaceuticals  are used in the field of nuclear medicine as radioactive tracers in the diagnosis and treatment of many diseases. A radioactive tracer is a chemical compound with an attached radioactive isotope [a variant of a chemical element] that can be introduced into and tracked within the body.Through a complex process, these radioactive isotopes undergo radioactive decay, resulting in the emission of particles such as alpha or beta particles. Radioactive isotopes are used primarily either for their chemical properties or as a source of radiationIn cancer biology: A cancer treatment in which high energy beams are used to kill cancer cells. Radiation can also cause genetic damage that can lead to cancer. As an example, skin cancer is believed to be greatly increased by exposure to ultraviolet (UV) radiation from the sun.. Radionuclides of similiar elements can serve as radioactive tracers because they are similar chemically to the non-radioactive elements.There are some radionuclides that are bone seeking radioisotopes and those radionuclides exhibit chemical behavior similar to calcium, allowing them to be absorbed in areas where cancer is present in the bone. Once in the bone, the radioisotope emits beta or alpha particles, which kill the nearby cancer cells. 

How Xofigo Is Given: 

  • Xofigois given through a vein (intravenously, IV), as a slow [intravenous] injection, over about 1 minute. 

  • There is no pill form of Xofigo. 

  • It is given in a clinic or facility where healthcare providers or technicians have been trained to give radiation therapy. 

  • It is given once every 4 weeks for a maximum of 6 doses. 

Mechanism:

The active moiety of Xofigo is the alpha particle-emitting isotope radium-223 (as radium Ra 223 dichloride), which mimics calcium and forms complexes with the bone mineral hydroxyapatite at areas of increased bone turnover, such as bone metastasesTumor growths located at a location distinct from the initial site of cancer development. See the animation at ' metastasize '.. The high linear energy transfer of alpha emitters (80 keV/micrometer) leads to a high frequency of double-strand DNAAbbreviation for deoxyribonucleic acid. Composed of very long strings of nucleotides, which are abbreviated as A, C, G and T. DNA is the storage form of our genetic material. All of the instructions for the production of proteins are encoded in our DNA. breaks in adjacent cells, resulting in an anti-tumor effect on bone metastases. The alpha particle range from radium-223 dichloride is less than 100 micrometers (less than 10 cell diameters) which limits damage to the surrounding normal tissue.

Side effects:

The following side effects are common (occurring in greater than 10%) for patients taking Xofigo: 

  • Nausea 

  • Vomiting 

  • Diarrhea 

  • Swelling of the lower legs and hands [peripheral edema] 

  • Low blood counts. Your white and red blood cells and platelet counts may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding. 

These are less common (occurring in 1-5%) side effects for patients receiving Xofigo: 

  • Dehydration 

  • Injection site reactions (redness, pain, swelling) 

  • Kidney failure / impairment 

Not all side effects are listed above. You should always inform your health care provider if you experience any unusual symptoms.