Key Clinical Summary: 

• Design/Population: The phase 3 EORTC 1333/PEACE-3 trial enrolled and randomized patients with metastatic castration-resistant prostate cancer and bone metastases to receive enzalutamide with or without 6 cycles of radium-223. 
• Key Outcomes: The addition of radium-223 significantly improved overall survival and confirmed radiographic progression-free survival benefit, with a manageable increase in adverse events.
• Clinical Relevance: Enzalutamide plus radium-223 represents an effective first-line option for patients with bone-predominant metastatic castration-resistant prostate cancer, offering meaningful survival benefit with acceptable toxicity when combined with bone-protective therapy.

Bertrand Tombal, MD, PhD, Université Catholique de Louvain, Brussels, Belgium, discusses final overall survival results from the EORTC 1333/PEACE-3 trial evaluating enzalutamide with or without radium-223 in patients with metastatic castration-resistant prostate cancer and bone metastases. 

The addition of radium-223 significantly improved overall survival and radiographic progression-free survival compared with enzalutamide alone. The combination demonstrated a manageable safety profile, supporting its use as a first-line treatment option in bone-predominant metastatic castration-resistant prostate cancer. 

These results were presented by Enrique Gallardo, Parc Taulí University Hospital, Sabadell, Spain, at the 2026 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium in San Francisco, California.

Source:

Gallardo E, Tombal BF, Choudhury A, et al. Final overall survival results from the EORTC 1333/PEACE-3 trial: Enzalutamide with or without radium-223 in metastatic castration-resistant prostate cancer. Presented at ASCO GU. February 26 - 28, 2026. San Francisco, California. Abstract 15.