As someone who delivers a lot of radium-223, I’m sometimes frustrated that, when a patient is referred to me bed-ridden and heavily pretreated, no one ever really gave a thought to using radium early. We know from the original ALSYMPCA (Alpharadin in Symptomatic Prostate Cancer Patients) trial that only about 58% of patients got all 6 infusions. When I see a patient who is heavily pretreated, I know I am not going to be able to give him all of the medication. If I see someone who is early on in the process – where he has early symptomatic castrate-resistant prostate cancer (CRPC) and some metastases – that is the type of patient I think we can have the greatest impact on. We’ve seen some studies now indicating that asymptomatic patients were more likely to have a better prognosis and a longer disease-free survival, or rather, secondary skeletal event symptoms, as well as overall survival. Then there’s also some interesting laboratory evidence suggesting that radium-223 may impact the cancer cells so that they can be more susceptible to T cell-mediated lysis. That interaction, although we’re going to need the bigger studies to see how to combine these drugs, supports earlier intervention in symptomatic patients, where it’s appropriate, and is something that we should be shifting toward.