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We examined treatment patterns and real-world overall survival (rwOS) of men with mCRPC treated with Ra-223 in the modern treatment era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of men treated with Ra-223 was derived using private insurance data from the Komodo Health dataset from January 1, 2017 to June 30, 2022. Cox-regression analyses examined associations between Ra-223 use and rwOS with adjustment for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1376 men, the median age was 68 years, 51% were White, and 89% had bone-only metastases. Overall, 17%, 35%, and 25% of men received Ra-223 as first-line, second-line, or third-line treatment for mCRPC, respectively. Thirty-six percent received Ra-223 as combination\/layered therapy, mainly with enzalutamide, and 46% completed \u22655 cycles. Overall, median rwOS was 22.9 months. Median rwOS was longer in men who completed \u22655 Ra-223 cycles versus 1\u20134 cycles (30.3 versus 15.3 months) and combination\/layered therapy versus monotherapy (26.6 versus 20.5 months). Combination\/layered therapy and completion of \u22655 Ra-223 cycles were associated with 22% and 55% reductions in risk of death in adjusted analyses, respectively. Limitations include some clinical information not captured by claims databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant rwOS benefits were identified in men who received Ra-223 as an earlier line of therapy, received Ra-223 in combination with another therapy, and completed \u22655 Ra-223 cycles, underscoring the importance of Ra-223 in the current treatment landscape.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-025-00969-6","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T23:25:30Z","timestamp":1743809130000},"page":"960-967","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Real-world utilization patterns and survival in men with metastatic prostate cancer treated with Radium-223 in the United States"],"prefix":"10.1038","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8265-8612","authenticated-orcid":false,"given":"Amit D.","family":"Raval","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqiao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Korn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niculae","family":"Constantinovici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-7963","authenticated-orcid":false,"given":"Rana R.","family":"McKay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"969_CR1","unstructured":"Xofigo Prescribing Information. 2019. 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RM reports consulting fees for Ambrx, Arcus, AstraZeneca, Aveo, Bayer, Bristol-Myers Squibb, Calithera, Caris, Dendreon, Eisai, Exelixis, Johnson & Johnson, Lilly, Merck, Myovant, NeoMorph, Novartis, Pfizer, Sanofi, SeaGen, Sorrento Therapeutics, Telix, Tempus; and institutional research support for Artera, AstraZeneca, Bayer, Tempus, Oncternal, Bristol-Myers Squibb, Exelixis.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}