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Cancers
Special Issues
Advances and Research Priorities for Metastatic-Hormone-Resistant Prostate Cancer
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Advances and Research Priorities for Metastatic-Hormone-Resistant Prostate Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Metastasis".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 388

Special Issue Editor

Dr. Bassel Nazha

E-Mail Website
Guest Editor
Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA
Interests: prostate cancer; genitourinary cancer; renal cell carcinoma; penile cancer; blad-der cancer; urothelial cancer

Special Issue Information

Dear Colleagues,

This Special Issue will cover the advances and research priorities for metastatic-hormone-resistant prostate cancer. It will include the sequencing of combination therapies, highlighting novel molecular targets such as DDL3 and the emerging use of PARP inhibitors and radiopharmaceuticals as a standard of care treatment options. The Special Issue will also adopt the precision oncology viewpoint and highlight the role of ctDNA for real-time treatment personalization and monitoring. Papers on novel theragnostics and PSMA-targeted therapies are welcome in addition to ones highlighting the role of radiation therapy in hormone-resistant disease. Lastly, the Special Issue will include the need for a clinical trial design that investigates symptom and quality of life (QOL) outcome measures. Additionally, papers focused on understanding the real-world effectiveness and patient-centered benefits of new therapies are welcome.

I look forward to receiving your contributions.

Dr. Bassel Nazha
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • combination therapy
  • precision oncology
  • ctDNA
  • radiation therapy

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (1 paper)

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Research

18 pages, 2438 KiB  
Article
Cost-Effectiveness of PARP Inhibitors for Patients with BRCA1/2-Positive Metastatic Castration-Resistant Prostate Cancer—The Canadian Perspective
by Ivan Yanev, Armen G. Aprikian, Brendan L. Raizenne and Alice Dragomir
Cancers 2025, 17(1), 40; https://doi.org/10.3390/cancers17010040 - 26 Dec 2024
Viewed by 239
Abstract
Background/Objectives: Through phase III clinical trials, PARP inhibitors have demonstrated outcome improvements in mCRPC patients with alterations in BRCA1/2 genes who have progressed on a second-generation androgen receptor pathway inhibitor (ARPI). While improving outcomes, PARP inhibitors contribute to the ever-growing economic burden of [...] Read more.
Background/Objectives: Through phase III clinical trials, PARP inhibitors have demonstrated outcome improvements in mCRPC patients with alterations in BRCA1/2 genes who have progressed on a second-generation androgen receptor pathway inhibitor (ARPI). While improving outcomes, PARP inhibitors contribute to the ever-growing economic burden of PCa. The objective of this project is to evaluate the cost-effectiveness of PARP inhibitors (olaparib, rucaparib, or talazoparib) versus the SOC (docetaxel or androgen receptor pathway inhibitors (ARPI)) for previously progressed mCRPC patients with BRCA1/2 mutations from the Canadian healthcare system perspective. Methods: Partitioned survival models were created to represent mCRPC disease after progression until death. Survival inputs for BRCA1/2-mutated patients were extracted from the PROfound, TRITON3, and TALAPRO-1 clinical trials, while Canadian-specific costs are presented in 2023 dollars. Upon progression, patients were treated with chemotherapy. The considered time horizon was 5 years and outcomes were discounted at 1.5% per year. Results: PARP inhibitors provide an additional survival of 0.19 quality-adjusted life years (QALY) when compared to the current standard of care, with additional costs of CAD 101,679 resulting in an incremental cost-utility ratio (ICUR) of CAD 565,383/QALY. The results were most sensitive to PARP inhibitors’ acquisition costs and health-state utilities. PARP inhibitors required price reductions of up to 83% to meet the CAD 50,000/QALY willingness-to-pay threshold (WTP). Conclusions: While providing survival benefits to previously progressed mCRPC patients presenting deleterious BRCA1/2 gene mutations, PARP inhibitors are not cost-effective and require major price reductions to reach local WTP thresholds. Full article
(This article belongs to the Special Issue Advances and Research Priorities for Metastatic-Hormone-Resistant Prostate Cancer)
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Figure 1

Figure 1
<p>Partitioned survival model structure.</p> Full article ">Figure 2
<p>Tornado diagram of deterministic sensitivity analysis. Parameter increase is expressed in red, while blue denotes parameter decrease. Expected value (EV) indicates base case ICER results.</p> Full article ">Figure 3
<p>Cost-effectiveness acceptability curve (willingness-to-pay displayed in Canadian dollars).</p> Full article ">Figure A1
<p>Validation of the best-fitted parametric curves on reconstructed Kaplan–Meier curves from PROfound, TRITON3, and TALAPRO-1. Panel (<b>A</b>), olaparib survival data; Panel (<b>B</b>), rucaparib survival data; Panel (<b>C</b>), docetaxel survival data; Panel (<b>D</b>), ARPI survival data; Panel (<b>E</b>), Talazoparib survival data. Digitized overall survival (OS) curve from clinical trials in grey; digitized progression-free survival (PFS) curve from clinical trials in yellow; modelled PFS curve in blue; modelled OS curve in orange. (ARPI, androgen receptor pathway inhibitors).</p> Full article ">Figure A2
<p>Cost-effectiveness frontier.</p> Full article ">Figure A3
<p>Incremental cost-effectiveness scatterplot, PARP inhibitors vs. standard of care. Green ellipsis represents 95% confidence interval.</p> Full article ">
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