Sartor AO, et al. - In this retrospective patient chart review, researchers analyzed patterns of current use of radium-223 (RA-223) in a real world setting in metastatic castration resistant prostate cancer (mCRPC) patients. Participants were recruited from 10 centers throughout the US (four academic, six private practices) and included 200 patients (mean age-73.6 years, mean Charlson comorbidity index-6.9) who received at least 1 cycle of Ra-223 for mCRPC, with a minimum follow-up of 4 months or placement in hospice. Addressing clinical features and treatment outcomes, descriptive analyses were carried out. On average, 1.6 years from mCRPC diagnosis, treatment with RA-223 was started (first line use (1L)=38.5%, 2L=31.5% and ≥3L=30%). Compared with clinical trial data, the real world data analyzed in this study highlighted a distinct utilization of RA-223. RA-223 in combination with abiraterone or enzalutamide was used to treat the majority of the patients; these therapies were unavailable when the pilot trial was conducted. Median survival of 21.2 months was reported. With the FDA approval of newer agents in bone-metastatic CRPC, real world use of RA-223 has changed.