Xofigo

Xofigo is the brand name for radium-223 dichloride, a radiopharmaceutical used in the treatment of metastatic castration-resistant prostate cancer (mCRPC) with symptomatic bone metastases and no known visceral metastases. It was developed by Algeta and marketed by Bayer. In the United States, Xofigo received FDA approval in 2013 and has since been approved in several other regions, with labeling that specifies its use for patients with bone-dominant disease.

Xofigo works as an alpha-emitting radiopharmaceutical. Radium-223 behaves similarly to calcium and tends to localize to areas of increased bone formation, such as osteoblastic bone metastases. The emitted alpha particles deliver high-energy radiation over a short range, causing double-strand DNA breaks in nearby cancer cells while minimizing damage to surrounding healthy tissue. This targeted approach aims to reduce tumor burden in bone metastases and may improve clinical outcomes without the broader systemic toxicity seen with some other treatments.

Administration of Xofigo is via intravenous injection at a dose of 55 kilobecquerels per kilogram of body weight, given every four weeks for a total of six injections. The treatment schedule is designed to balance efficacy with tolerability, and patients are typically monitored with periodic blood counts and clinical assessments to detect hematologic toxicity or other adverse effects.

Common adverse effects reported during Xofigo treatment include diarrhea, nausea, vomiting, and hematologic events such as anemia and thrombocytopenia. Because of potential marrow suppression, patients require careful monitoring, and the use of Xofigo is generally avoided in those with significant bone marrow suppression or in combination with other myelosuppressive therapies unless advised by a clinician.

Xofigo provides a targeted option for men with symptomatic bone metastases from mCRPC and no known visceral metastases, complementing other systemic therapies while emphasizing bone-specific disease control.