LBA-12 CALGB 90203 (ALLIANCE): RADICAL PROSTATECTOMY WITH OR WITHOUT NEOADJUVANT CHEMOHORMONAL THERAPY IN MEN WITH CLINICALLY LOCALIZED, HIGH RISK PROSTATE CANCER
Notice bibliographique
Résumé
You have accessJournal of UrologySunday Next Frontier (LBA)1 Apr 2019LBA-12 CALGB 90203 (ALLIANCE): RADICAL PROSTATECTOMY WITH OR WITHOUT NEOADJUVANT CHEMOHORMONAL THERAPY IN MEN WITH CLINICALLY LOCALIZED, HIGH RISK PROSTATE CANCER James A. Eastham*, Glenn Heller, Susan Halabi, J. Paul Monk, Himisha Beltran, Martin Gleave, Christopher P. Evans, Steven K. Clinton, Russell Z. Szmulewitz, Jonathan Coleman, David W. Hillman, Colleen Watt, Olwen M. Hahn, Mary-Ellen Taplin, Eric J. Small, James Mohler, and Michael J. Morris James A. Eastham*James A. Eastham* More articles by this author , Glenn HellerGlenn Heller More articles by this author , Susan HalabiSusan Halabi More articles by this author , J. Paul MonkJ. Paul Monk More articles by this author , Himisha BeltranHimisha Beltran More articles by this author , Martin GleaveMartin Gleave More articles by this author , Christopher P. EvansChristopher P. Evans More articles by this author , Steven K. ClintonSteven K. Clinton More articles by this author , Russell Z. SzmulewitzRussell Z. Szmulewitz More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , David W. HillmanDavid W. Hillman More articles by this author , Colleen WattColleen Watt More articles by this author , Olwen M. HahnOlwen M. Hahn More articles by this author , Mary-Ellen TaplinMary-Ellen Taplin More articles by this author , Eric J. SmallEric J. Small More articles by this author , James MohlerJames Mohler More articles by this author , and Michael J. MorrisMichael J. Morris More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557504.00464.d6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Radical prostatectomy (RP) is a mainstay of treatment for men with clinically localized, high risk prostate cancer (CLHRPC). We assessed whether chemohormonal therapy with androgen deprivation therapy (ADT) plus docetaxel followed by RP would result in improved biochemical progression free survival (bPFS) than RP alone. METHODS: CALGB 90203 (Alliance) is a Phase III study which randomly assigned in a 1:1 fashion men with CLHRPC (biopsy Gleason Grade Group 4 or 5 or Kattan pre-op nomogram bPFS < 60%) to RP alone or RP plus neoadjuvant ADT plus docetaxel (75 mg per square meter of body-surface area every 3 weeks for 6 cycles). The primary objective was to test the hypothesis that 3-year bPFS would be longer in the neoadjuvant chemohormonal therapy arm. Secondary endpoints included overall bPFS and overall survival (OS). The events for the bPFS endpoint are progression, defined as a serum PSA level > 0.2 ng/ml and rising on 2 separate occasions at least 3 months after RP, and death. RESULTS: A total of 788 men (median age, 62; range: 32-83 years) were randomized. With a median follow-up of 5.1 years (range 0-11.2 years), no difference was seen in 3-year bPFS in men receiving neoadjuvant chemohormonal therapy and RP compared to RP alone (0.87 vs 0.82; p = 0.13; Figure). Expanding to the entire follow-up period, the bPFS rate was improved for the neoadjuvant arm (HR = 0.66; 95%CI: 0.47-0.94; Figure), however, the interpretation for the bPFS analyses was problematic due to 42% of patients not being evaluable for the primary endpoint because of receiving additional treatment prior to meeting the primary endpoint. An OS treatment evaluation provided evidence that patients randomized to neoadjuvant chemohormonal therapy and RP in this study had an improved OS rate relative to the RP-alone arm (HR = 0.67; 95% CI: 0.43-1.06). CONCLUSIONS: Neoadjuvant ADT plus docetaxel followed by RP did not increase 3-year bPFS compared to RP alone in men with CLHRPC. There was evidence that over time, bPFS and OS were improved in the men receiving neoadjuvant chemohormonal therapy and RP versus the men receiving RP alone. However, the 42% non-evaluable rate for bPFS tempers enthusiasm for the bPFS endpoint results. Source of Funding: U10CA180821, U10CA180882, U10CA180863 (CCTG), U10CA180888 (SWOG), and Sanofi-Aventis. ClinicalTrials.gov Identifier: NCT00430183. New York, NY; Durham, NC; Columbus, OH; New York, NY; Vancouver, Canada; Sacramento, CA; Columbus, OH; Chicago, IL; New York, NY; Rochester, MN; Chicago, IL; Boston, MA; San Francisco, CA; Buffalo, NY; New York, NY© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e997-e997 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information James A. Eastham* More articles by this author Glenn Heller More articles by this author Susan Halabi More articles by this author J. Paul Monk More articles by this author Himisha Beltran More articles by this author Martin Gleave More articles by this author Christopher P. Evans More articles by this author Steven K. Clinton More articles by this author Russell Z. Szmulewitz More articles by this author Jonathan Coleman More articles by this author David W. Hillman More articles by this author Colleen Watt More articles by this author Olwen M. Hahn More articles by this author Mary-Ellen Taplin More articles by this author Eric J. Small More articles by this author James Mohler More articles by this author Michael J. Morris More articles by this author Expand All Advertisement PDF downloadLoading ...
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 | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,037 | 0,005 |
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 ».