Volume 24, Number 1Prostate CancerUse of Radium-223 in Advanced Prostate CancerSoumyajit RoyAngela Y. JiaPedro C. BarataDaniel E. SprattRadium-223 dichloride (Ra-223) is a life-prolonging therapeutic option for castration-resistant prostate cancer with symptomatic bone metastases. As an α-emitting osteotropic radiopharmaceutical, Ra-223 selectively targets areas of increased bone turnover. Recent evidence from the PEACE III randomized trial demonstrated a radiographic progression-free survival and overall survival benefit with a combination of Ra-223 and enzalutamide, provided appropriate bone health measures are in place. There is also a growing body of evidence on the use of Ra-223 in metastatic hormone-sensitive prostate cancer. Robust phase 3 data, however, are needed to define its optimal integration into the current standard of care for these patients.Radioisotopesprostatic neoplasms, castration-resistantmetastatic hormone-sensitive prostate cancerProstatic neoplasms