Reply to S.M. Sorscher et al
Notice bibliographique
Résumé
The hypothesis put forward by Sorscher et al 1 to explain survival differences in the subgroup of patients with multiple myeloma (MM) who were described in our article 2 bears consideration, and the potential effect of zoledronic acid on survival in patients with MM and Ras mutation will require additional study.However, an alternative hypothesis is that the survival findings in our study are spurious.As noted in our article, 2 differences in prognostic variables at study entry and differences in on-study antineoplastic treatments in the small cohort of patients with MM may confound the interpretation of survival in our study, which was primarily designed to evaluate complications of bone metastases.This alternative hypothesis is also supported when comparing the trial results with other recently published data on survival in MM.In the well-conducted Myeloma IX study, 3 which forms the clinical basis for the hypothesis proposed by Sorscher et al, 1 a survival benefit for zoledronic acid in comparison with clodronate was claimed.The 1-year survival rate of patients who were treated in this study was 80% for zoledronic acid, a rate nearly identical to the 1-year survival rate of 83% for patients with MM who were treated with denosumab in our study.However, the 1-year survival rate for patients with MM who were treated with zoledronic acid in our study was 96%-a rate substantially higher than the 80% survival rate with zoledronic acid in the Myeloma IX study.In addition, the 1-year survival rate for patients with MM who were treated with denosumab is consistent with published reports of similar patients from large epidemiologic and population-based database studies (72% to 83%) and from controlled clinical studies that have used either pamidronate or a placebo (78%). [4]5][6][7] Given these comparisons, it is reasonable to hypothesize that the survival difference seen in our study is an artifact.On the basis of multiple preclinical findings 8-10 that indicate a significant role for the receptor activator of nuclear factor kappa-B ligand pathway in the pathogenesis of myeloma bone disease and the need to continue to improve the lives of patients with MM, an adequately powered, phase III denosumab study is being initiated.The study compares denosumab with zoledronic acid in a fashion similar to that described in our article 2 and includes appropriate stratification of key MM baseline prognostic factors for survival and of antimyeloma treatments as well as skeletal-related events.The study will additionally inform on the efficacy and safety of denosumab in this patient population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,038 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,004 | 0,005 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,038 | 0,050 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,010 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».