An Injectable Pharmaceutical to Relieve Bone Pain in Patients with Painful Cancer Metastases to the Bone
Up to 80% of Patients Report Pain Relief Lasting Months1
Strontium Chloride Sr-89 Injection, USP (Strontium-89) is a non-opioid radioactive pharmaceutical injection to relieve bone pain in patients with painful skeletal metastases. In the body, strontium exerts its effect through its selective accumulation in and around skeletal metastases.2 As a calcium analog, strontium is taken up by active bone tissue present around metastatic tumor cells, especially around osteoblastic tissue. Strontium then irradiates tumors cells from the adjacent bone tissue. The ratio between the dose deposited on a metastasis and normal bone is 8-40. Unabsorbed isotope is excreted in the urine in the first few days following injection.3
Multiple studies have confirmed that Strontium-89 has a palliative effect on pain caused by bone metastases.3 In a multi-center Canadian placebo-controlled trial of 126 patients, pain relief occurred in more patients treated with a single injection of Strontium-89 than in patients treated with an injection of placebo.2
In a study of 500 patients with skeletal metastases from prostate and breast cancer, an overall response rate of 80% was seen after 3 months, with 10 to 20% of patients reporting complete freedom from pain.4 Another study found a 33% complete response rate (“dramatic improvement”) to Strontium-89, compared with no response after placebo.5
Strontium Chloride Sr-89 Injection, USP can be used in combination with analgesics and used concomitantly or sequentially with external beam radiotherapy and bisphosphonates.6 Strontium-89 injection is a pure beta emitter, and selectively irradiates sites of primary and metastatic bone involvement with minimal irradiation of soft tissues distant from bone lesions. The presence of bone metastases should be confirmed prior to therapy.2
- Giammarile F, Mognetti T, Resche I. Bone pain palliation with strontium-89 in cancer patients with bone metastases. Q J Nucl Med. 2001;45(1):78-83.
- STRONTIUM CHLORIDE Sr-89 Injection [package insert]. Bio-Nucleonics Pharma Inc.; 2003.
- Jager PL, Kooistra A, Piers DA. Treatment with radioactive (89)strontium for patients with bone metastases from prostate cancer. BJU Int. 2000;86(8):929-934.
- Robinson RG. Strontium-89 precursor targeted therapy for pain relief of blastic metastatic disease. Cancer 1993; 72:3433-5
- Lewington VJ, McEwan AJ, Ackery DM, Bayly RJ, Keeling DH, Macleod PM, et al. A prospective, randomised double-blind crossover study to examine the efficacy of strontium-89 in pain palliation in patients with advanced prostate cancer metastatic to bone. Eur J Cancer. 1991; 27: 954-958.
- Handkiewicz-Junak D, Poeppel TD, Bodei L, Aktolun C, Ezziddin S, Giammarile F, et al. EANM guidelines for radionuclide therapy of bone metastases with beta-emitting radionuclides. Eur J Nucl Med Mol Imaging. 2018;45(5):846-859.