The Combination Therapy With Ra-223 and Enzalutamide

Inclusion Criteria

• •1. Patients diagnosed as CRPC
• •2. Surgical or those who will be treated with luteinizing hormone-releasing hormone (LHRH) agonists throughout the study period,
• •3. Patients who had \>30% of PSA response to enzalutamide prior to enrollment,
• •4. Interval between PSA progression and enrollment is up to 3 months,
• •5. With bone metastases (≥ 2 hot spots) on bone scintigraphy within previous 24 weeks,
• •6. No intention to use anti-cancer chemotherapy within the next 6 months,
• •7. Eastern Cooperative Oncology Group performance status (ECOG-PS): 0-1,
• •8. Life expectancy ≥ 6 months,
• •9. Laboratory requirements within 30 days before enrollment:
• •* Absolute neutrophil count (ANC) ≥ 1.5 x 10e9/L,
• •* Platelet count ≥ 100 x 10e9/L,
• •* Hemoglobin ≥ 10.0 g/dL,
• •* Total bilirubin level ≤1.5 institutional upper limit of normal (ULN),
• •* Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 ULN,
• •* Creatinine ≤ 1.5ULN, and estimated glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2,
• •10. Age ≥ 20,
• •11. Ability to understand and the willingness to sign a written informed consent (IC).