Phase II Randomized Trial of Radium-223 Dichloride and Cabozantinib in Patients With Renal Cell Carcinoma With Bone Metastases: RADICAL (Alliance A031801)

The RADICAL (Alliance A031801) phase II randomized trial evaluated the combination of the bone-targeting alpha-emitting radiopharmaceutical radium-223 dichloride with the multikinase inhibitor cabozantinib in patients with renal cell carcinoma metastatic to bone. The study, published in the Journal of Clinical Oncology, addresses an unmet need in RCC patients with skeletal metastases, a subgroup associated with poorer prognosis and increased skeletal-related events. This combination rationale pairs cabozantinib's established activity in advanced RCC with radium-223's bone-specific cytotoxic mechanism previously validated in prostate cancer.