A national multicenter study on overall survival in elderly metastatic castrate-resistant prostate cancer patients treated with Radium-223

Background Radium-223 prolongs overall survival (OS) and delays time to the rst symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and e cacy of Radium-223 treatment in the very elderly population. Aims Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are di erences between young and elderly, as well as to verify e cacy and safety in patients ≥ 75 years of age. Methods 430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients’ parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old). Results 47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show signi cant di erences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no signi cant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic e ects are similar in the two groups. Conclusions Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents.