Exceptional Duration of Radium-223 in Prostate Cancer With a BRCA2 Mutation


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Abstract

Clinical Practice PointsIt is now recognized that patients with prostate cancer have a higher rate of DNA repair gene mutations than previously appreciated.The prevalence of germline alterations in DNA repair genes may be as high as 11.8% in patients with metastatic prostate cancer.Several targeted agents for DNA repair defects (poly ADP ribose polymerase inhibitors and platinums) have shown increased sensitivity in the setting of biallelic breast cancer susceptibility gene 2 (BRCA2) loss.The mechanism of action of Radium-223, a bone-targeted radiopharmaceutical, raises the possibility of clinical exploitation among patients with a BRCA2 mutation.We hypothesize that the extraordinary duration of disease control with Radium-223 described herein is owing to the presence of a unique sensitivity in patients with a BRCA2 mutation.

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