The Bone Pathway: 223Ra-Dichloride

Several beta-emitting radiopharmaceuticals, including 89Sr-chloride, 186Re-hydroxyethylidene diphosphonate, and 153Sm-ethylene diamine tetramethylene phosphonate, have been developed for palliation of bone pain due to metastases. 223Ra dichloride is a novel bone-seeking alpha emitter used for treatment of CRPC in patients with bone metastases. It is a calcium-mimetic solution that selectively targets area of increased bone turnover in bone metastases. First clinical studies with 223Ra started in 2012. This chapter aims to describe the employment of 223Ra-dichloride in clinical setting by analyzing the different clinical trials and future perspectives for this targeted nuclear medicine therapy.