Xofigo Probably Can Be Used More Than Once

We have good news for men with castrate-resistant metastatic prostate cancer (CRPC) who have painful bone metastases.  

Early results from an international, open-label, phase 1/2 trial (NCT01934790) showed that it is possible to successfully re-treat men with the drug known as Xofigo (Ra-223).  The study found that when used a second time, Xofigo was well tolerated and that it provides favorable effects on the cancer’s progression.  

The current FDA label for Xofigo, which is an alpha-emitting radio-pharmaceutical, allows for just one round of treatment for men with castration-resistant prostate cancer (CRPC) who have painful bone metastases (mets).   The label also allows for the simultaneous use of abiraterone (Zytiga) or enzalutamide (Xtandi).

In this small study, the researchers found that there were no serious drug-related side effects for the 44 men who participated in the trial.  

This study should give you and your oncologist more confidence that you can have two rounds of Xofigo to treat your bone mets that come from castrate-resistant prostate cancer.  However, at this time you might have difficulty getting your insurance company to cover a second round of Xofigo. 

This study is scheduled to continue for another five years. 


O. Sador, et al.  Annals of Oncology, Volume 28, Issue 10, 1 October 2017, Pages 2471, https://doi.org/10.1093/annonc/mdx331