A comment article advises the oncology community to interpret these findings cautiously since the trial was not able to identify the optimum sequence of administration of docetaxel and radium-233. It notes that as the trial was designed before the approval of enzalutamide and abiraterone acetate, the clinical benefit of concomitant or sequential use of radium-223 with these drugs is unknown. Furthermore, though most patients had a clinical benefit, some subgroups had increased toxic effects and questionable clinical benefit thus identification of early and continuous markers of response will be crucial to allow optimisation of the duration of radium-223 treatment, especially now that patients with metastatic castration-resistant prostate cancer have several treatment options.