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Radium-223 + sipuleucel-T is a combination therapy being investigated for the treatment of bone-metastatic castration-resistant prostate cancer (mCRPC). Radium-223 (Xofigo) is an alpha-emitting radiopharmaceutical that acts as a calcium mimetic, selectively targeting areas of high bone turnover associated with metastases to deliver high-energy, short-range alpha radiation that induces DNA double-strand breaks. Sipuleucel-T (Provenge) is an autologous cellular immunotherapy composed of peripheral blood mononuclear cells, including antigen-presenting cells, that have been activated ex vivo with a recombinant fusion protein (PA2024) containing prostatic acid phosphatase (PAP). The combination, evaluated in a Phase 2 trial (NCT02463799) led by the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, aims to enhance the anti-tumor immune response by combining localized radiation-induced cell death with systemic immunotherapy.
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