The Absolute Effect / Evidence index
Advanced / Metastatic · Phase II randomized; N=98 RCC with bone metastases. Cabozantinib+radium-223 vs cabozantinib. Primary endpoint symptomatic skeletal event-free survival. · Median SSE-FS 16.7 vs 17.6 months
RADICAL / Alliance A031801
Clinical question: Does radium-223 added to cabozantinib improve symptomatic skeletal event-free survival in RCC with bone metastases?
Median SSE-FS 16.7 vs 17.6 months; HR 1.46 (90% CI 0.86–2.51; P=0.12). Median PFS 10.3 vs 10.5 months (HR 1.37; P=0.32); trial closed at futility. · Registry:
Design, population and treatment
Phase II randomized; N=98 RCC with bone metastases. Cabozantinib+radium-223 vs cabozantinib. Primary endpoint symptomatic skeletal event-free survival.
Key efficacy outcome
Grade ≥3 treatment-related AEs 65.9% vs 56.8%; no consistent subgroup benefit.
Safety and absolute effect
Median SSE-free survival (months)
https://pmc.ncbi.nlm.nih.gov/articles/PMC13489773/
Interpretation and limitations
Current-practice context · 14 November 2026: Primary publication/abstract and trial identifier checked. Guideline-level current-practice mapping was not established in this publication-led batch; no NCCN citation provenance is claimed. Where detailed QoL, follow-up or toxicity data were not present in the retrieved abstract, they are not inferred.