{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T01:06:26Z","timestamp":1773018386492,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Advances in Urology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Radium\u2010223 and enzalutamide have shown survival benefits in metastatic castration\u2010resistant prostate cancer, and recent trial data suggest a potential synergy in combination. However, real\u2010world data on their combined use, especially regarding fracture risk and prior androgen receptor signaling inhibitor exposure, are limited. In this study, we aimed to evaluate the efficacy and safety of adding radium\u2010223 to enzalutamide compared with enzalutamide alone in patients with bone metastatic castration\u2010resistant prostate cancer. We retrospectively included patients treated with radium\u2010223 plus enzalutamide (the combination group) or enzalutamide alone (the enzalutamide group), and compared progression\u2010free survival, overall survival, prostate\u2010specific antigen kinetics, alkaline phosphatase kinetics, and treatment\u2010emergent adverse events. A total of 17 and 18 patients were included in the combination and enzalutamide groups, and the median age and follow\u2010up duration were 75\u2009years and 23\u2009months, respectively. The median progression\u2010free survival was significantly longer in the combination group (22\u2009months [95% confidence interval (CI): 16.7\u201332.4]) than that in the enzalutamide group (5\u2009months [95% CI: 6.3\u201325.2],\n                    <jats:italic>p<\/jats:italic>\n                    = 0.048). However, there was no significant difference in overall survival (combination: not reached [95% CI: 31.1\u201344.8] vs. enzalutamide: not reached [95% CI: 28.9\u201356.5],\n                    <jats:italic>p<\/jats:italic>\n                    = 0.602). In the combination group, there was no significant difference in progression\u2010free and overall survival between patients with and without prior androgen receptor signaling inhibitor therapy. Fractures occurred in one (5.9%) and two (11.1%) patients in the combination and enzalutamide groups, respectively. In conclusion, the combination of radium\u2010223 and enzalutamide did not improve overall survival in patients with metastatic castration\u2010resistant prostate cancer. However, it significantly prolonged progression\u2010free survival without increasing the risk of fractures when bone health agents were administered. Furthermore, prior exposure to androgen receptor signaling inhibitors was not associated with oncological outcomes of the combination therapy.\n                  <\/jats:p>","DOI":"10.1155\/aiu\/2359934","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:11:13Z","timestamp":1773015073000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Outcomes of Combination Therapy With Radium\u2010223 and Enzalutamide Compared With Enzalutamide Alone in Patients With Metastatic Castration\u2010Resistant Prostate Cancer"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6857-7354","authenticated-orcid":false,"given":"Kenichi","family":"Hata","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuma","family":"Goto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-8223","authenticated-orcid":false,"given":"Masaki","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Takiguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Saito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1124-2322","authenticated-orcid":false,"given":"Yuki","family":"Enei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keigo","family":"Sakanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Hisakane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taisuke","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2599-8183","authenticated-orcid":false,"given":"Fumihiko","family":"Urabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7410-0712","authenticated-orcid":false,"given":"Takafumi","family":"Yanagisawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-4684","authenticated-orcid":false,"given":"Shunsuke","family":"Tsuzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5840-1284","authenticated-orcid":false,"given":"Tatsuya","family":"Shimomura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5673-1553","authenticated-orcid":false,"given":"Takahiro","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Tojo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohito","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_11_1_2","unstructured":"Global 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