Xofigo Radioligand Therapy
Xofigo® (Radium Ra 223 Dichloride)
Alpha-particle therapy for prostate cancer metastatic to bone
Overview
Xofigo is an intravenous alpha-particle–emitting radiopharmaceutical. Radium-223 behaves similarly to calcium and localizes to areas of increased bone turnover, including osteoblastic prostate cancer metastases. Its short-range alpha radiation delivers highly localized radiation to bone metastases.
FDA Approval and Who May Benefit
Xofigo is FDA approved for patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease. Patient selection requires careful review of disease distribution, symptoms, blood counts, prior and concurrent therapies, and overall treatment goals.
Why This Therapy/Imaging Is Useful
Radium-223 is designed specifically for bone-predominant metastatic prostate cancer. In the pivotal clinical trial supporting approval, treatment improved overall survival and delayed symptomatic skeletal events. Because alpha particles travel only a very short distance in tissue, radiation is concentrated near areas where radium-223 is deposited.
What to Expect / Typical Protocol
- Before treatment: Nuclear Medicine reviews recent imaging to confirm bone-predominant disease and absence of known visceral metastases, along with blood counts, clinical status, symptoms, and concurrent prostate cancer therapy.
- Treatment: Xofigo is administered intravenously once every 4 weeks for a total of 6 injections. The prescribed activity is weight based according to current FDA labeling.
- Monitoring: Complete blood counts are checked before treatment because bone-marrow suppression can occur. Treatment may be delayed or discontinued if blood-count recovery is inadequate.
- Bone health: The oncology team should review bone-protective therapy and fracture risk. Concurrent systemic treatments are coordinated according to current labeling and oncology guidelines.
- Radiation safety and follow-up: Patients receive practical instructions regarding bodily fluids and hygiene after treatment. Clinical response and subsequent oncologic management remain coordinated with the referring team.
Refer a Patient for Radium Ra 223 Dichloride (Xofigo®)
The Division of Nuclear Medicine at UTHealth Houston offers comprehensive evaluation and treatment with Xofigo® (Radium Ra 223 Dichloride) for eligible patients with metastatic prostate cancer.
Our multidisciplinary team provides:
- Comprehensive eligibility assessment
- Imaging review and treatment planning
- Coordination of laboratory testing and scheduling
- Administration of radioligand therapy
- Post-treatment imaging and follow-up in collaboration with the referring oncologist
How to Refer:
Community oncologists and other healthcare providers may refer patients by:
- Faxing the referral and relevant clinical records to: 713-704-1360
- Emailing one of our Nuclear Medicine faculty members by selecting a physician profile above.
Please include, when available:
- Recent clinic note
- Pathology reports
- Relevant imaging reports (including PSMA PET/CT, if performed)
- Recent laboratory results (CBC, CMP, renal and liver function tests)
- Current medication list and prior cancer treatments
Our team will promptly review the referral, contact the patient if appropriate, and coordinate consultation and treatment while maintaining close communication with the referring physician throughout the patient’s care.