Considering the Costs of Targeted Radionuclide Therapies in Prostate Cancer

Article Sidebar

February 2024 issue cover image
PDF Download
Published Mar 26, 2024
DOI: https://doi.org/10.18103/mra.v12i3.5043

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

M Vorster
University of KwaZulu-Natal, Department of Nuclear Medicine, Durban, South Africa
A Mallum
University of KwaZulu-Natal, Department of Oncology, Durban, South Africa
M Sathekge
Department of Nuclear Medicine University of Pretoria, Pretoria, South Africa
T Pascual
Department of Science and Technology (DOST), Philippine Nuclear Research Institute

Abstract

There is no denying the importance of prostate cancer as a leading cause of mortality and morbidity in men. As such, it represents an important driver of healthcare costs and there is a (mostly unmet) need to provide evidence that assists decision-makers in prioritizing one management strategy over another in budget planning.


Theranostics in prostate cancer represents a non-invasive out-patient strategy for patient management, which consists of imaging with a PSMA-based agent, followed by targeted radionuclide therapy with either a beta emitter (such as Lutetium-177) or an alpha emitter (such as Actinium-225). Evidence for these management approaches is mounting with FDA approval of imaging and therapy agents following landmark trials like the ProPSMA study, the VISION- and the TheraP trial. 


Despite the explosion in publications on the use of targeted radionuclide therapies in prostate cancer, studies that compare the cost-effectiveness of available nuclear medicine imaging and treatment strategies remain hard to find. The aim of this mini review was to summarize the most important current evidence related to cost-effectiveness strategies that evaluate imaging and targeted radionuclide therapies for PSMA-based PET theranostics.


We found a paucity of literature that deals with healthcare costs, with an obvious need for more cost-effectiveness studies to demonstrate the positive impact of nuclear medicine in the management of oncology (and other) patients. These studies need to be based on well-conducted clinical trials and meta-analyses, with appropriate model simulations and decision analysis and should ideally be reported according to the CHEERS 2022 guidelines to improve uniformity and robustness.

Keywords: Cost-effectiveness, Prostate cancer, targeted radionuclide therapy, Lu-177-PSMA, PRRT, CER, ICER, ACER, QALY

Article Details

How to Cite
VORSTER, M et al. Considering the Costs of Targeted Radionuclide Therapies in Prostate Cancer. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5043>. Date accessed: 23 nov. 2024. doi: https://doi.org/10.18103/mra.v12i3.5043.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 12 No 3 (2024): March issue, Vol.12, Issue 3
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J Clin. 2021;71(3):209-49.
2. Roehrborn CG, Black LK. The economic burden of prostate cancer. BJU int. 2011;108(6):806-13.
3. Gambhir SS, Schwimmer J. Economic evaluation studies in nuclear medicine: a methodological review of the literature. Q J Nucl Med Mol Imaging. 2000;44(2):121.
4. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, Gavin A, Visser O, Bray F. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J of cancer. 2018;103:356-87.
5. Husereau D, Drummond M, Augustovski F, de Bekker-Grob E, Briggs AH, Carswell C, Caulley L, Chaiyakunapruk N, Greenberg D, Loder E, Mauskopf J. Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations. Int J Technol Assess Health Care 2022;38(1):e13.
6. Yanovskiy M, Levy ON, Shaki YY, Zigdon A, Socol Y. Cost-Effectiveness Threshold for Healthcare: Justification and Quantification. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2022;59:00469580221081438.
7. Chisin R. Cost-effectiveness analysis. JNM. 2009;50(3):338-9.
8. Brockhuis B, Lass P, Popowski P, Scheffler J. An introduction to economic analysis in medicine-the basics of methodology and chosen terms. Examples of results of evaluation in nuclear medicine. Nucl Med Rev. 2002;5(1):55-9.
9. Adolfsson J, Steineck G, Whitmore Jr WF. Recent results of management of palpable clinically localized prostate cancer. Cancer. 1993;72(2):310-22.
10. Hricak H, Abdel-Wahab M, Atun R, Lette MM, Paez D, Brink JA, Donoso-Bach L, Frija G, Hierath M, Holmberg O, Khong PL. Medical imaging and nuclear medicine: a Lancet Oncology Commission. The Lancet Oncol. 2021;22(4):e136-72.
11. Garg H, Dursun F, Alsayegh F, Wang H, Wu S, Liss MA, Kaushik D, Svatek RS, Mansour AM. Revisiting current National Comprehensive Cancer Network (NCCN) high-risk prostate cancer stratification: a National Cancer Database analysis. Prostate Cancer and Prostatic Diseases. 2023;1-8.
12. Gillessen S, Bossi A, Davis ID, de Bono J, Fizazi K, James ND, Mottet N, Shore N, Small E, Smith M, Sweeney CJ. Management of patients with advanced prostate cancer—metastatic and/or castration-resistant prostate cancer: report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. Eur J of Cancer. 2023;185:178-215.
13. Hofman MS, Lawrentschuk N, Francis RJ, Tang C, Vela I, Thomas P, Rutherford N, Martin JM, Frydenberg M, Shakher R, Wong LM. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. The Lancet. 2020;395(10231):1208-16.
14. Taneja, S., A. Jena, R. Taneja, A. Singh, and A. Ahuja. "Sangeeta Taneja1 Amarnath Jena1 Rajesh Taneja2 Aru Singh1 Aashim Ahuja1." (2017).
15. Pozdnyakov A, Kulanthaivelu R, Bauman G, Ortega C, Veit-Haibach P, Metser U. The impact of PSMA PET on the treatment and outcomes of men with biochemical recurrence of prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2023;26(2):240-8.
16. Rovera G, Oprea-Lager DE, Ceci F. Health technology assessment for PSMA-PET: striving towards a cost-effective management of prostate cancer. Clin Transl Imaging. 2021;9(5):409-12.
17. Scholte M, Barentsz JO, Sedelaar JM, Gotthardt M, Grutters JP, Rovers MM. Modelling study with an interactive model assessing the cost-effectiveness of 68Ga prostate-specific membrane antigen positron emission tomography/computed tomography and nano magnetic resonance imaging for the detection of pelvic lymph node metastases in patients with primary prostate cancer. Eur Urol Focus. 2020;6(5):967-74.
18. de Feria Cardet RE, Hofman MS, Segard T, Yim J, Williams S, Francis RJ, Frydenberg M, Lawrentschuk N, Murphy DG, Lourenco RD. Is prostate-specific membrane antigen positron emission tomography/computed tomography imaging cost-effective in prostate cancer: an analysis informed by the proPSMA trial. Eur urol. 2021;79(3):413-8.
19. Song R, Jeet V, Sharma R, Hoyle M, Parkinson B. Cost-effectiveness analysis of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for the primary staging of prostate cancer in Australia. Pharmacoeconomics. 2022;40(8):807-21.
20. van der Sar EC, Keusters WR, van Kalmthout LW, Braat AJ, de Keizer B, Frederix GW, Kooistra A, Lavalaye J, Lam MG, van Melick HH. Cost-effectiveness of the implementation of [68Ga] Ga-PSMA-11 PET/CT at initial prostate cancer staging. Insights Imaging. 2022;13(1):1-0.
21. Holzgreve A, Unterrainer M, Calais J, Adams T, Oprea-Lager DE, Goffin K, Lopci E, Unterrainer LM, Kramer KK, Schmidt-Hegemann NS, Casuscelli J. Is PSMA PET/CT cost-effective for the primary staging in prostate cancer? First results for European countries and the USA based on the proPSMA trial. EJNMMI 2023;10:1-5.
22. Barnett CL, Davenport MS, Montgomery JS, Kunju LP, Denton BT, Piert M. 18F-choline PET/mpMRI for detection of clinically significant prostate cancer: part 2. Cost-effectiveness analysis. JNM. 2019;60(12):1705-12.
23. Rahbar K, Bodei L, Morris MJ. Is the vision of radioligand therapy for prostate cancer becoming a reality? An overview of the phase III VISION trial and its importance for the future of theranostics. JNM. 2019;60(11):1504-6.
24. Buteau JP, Martin AJ, Emmett L, Iravani A, Sandhu S, Joshua AM, Francis RJ, Zhang AY, Scott AM, Lee ST, Azad AA. PSMA and FDG-PET as predictive and prognostic biomarkers in patients given [177Lu] Lu-PSMA-617 versus cabazitaxel for metastatic castration-resistant prostate cancer (TheraP): a biomarker analysis from a randomised, open-label, phase 2 trial. The Lancet Oncol. 2022;23(11):1389-97.
25. Norum J, Traasdahl ER, Totth A, Nieder C, Olsen JA. Health economics and Radium-223 (Xofigo®) in the treatment of metastatic Castration-Resistant Prostate Cancer (mCRPC): A case history and a systematic review of the literature. Glob J Health Sci. 2016;8(4):1.
26. Mehrens D, Kramer KK, Unterrainer LM, Beyer L, Bartenstein P, Froelich MF, Tollens F, Ricke J, Rübenthaler J, Schmidt-Hegemann NS, Herlemann A. Cost-effectiveness analysis of 177Lu-PSMA-617 radioligand therapy in metastatic castration-resistant prostate cancer. J of NCCN. 2023;21(1):43-50.