Prednisone monotherapy in asymptomatic hormone refractory prostate cancer.
Bibliographic record
Abstract
BACKGROUND: Patients with advanced prostate cancer eventually cease to respond to hormonal therapy and thus progress to hormone refractory prostate cancer (HRPC). Prednisone has been used in this setting; however, limited data is available for this monotherapy in the asymptomatic HRPC population. OBJECTIVE: To evaluate the PSA response rate to prednisone in asymptomatic patients with hormone refractory prostate cancer (HRPC). Secondary objectives were to determine toxicity, predictors of response, and to determine overall survival of this population. METHODS: Patients with asymptomatic HRPC that were treated with low dose prednisone from April 1998 to 2003 were identified from the British Columbia Cancer Agency patient and pharmacy registries. Inclusion criteria were an ECOG Performance Status of 2 at the time of prednisone initiation, prior medical or surgical orchidectomy, a rising PSA, and no symptoms from prostate cancer. Demographic data, lab values, serial PSAs, and survival data were collected. Univariate analyses were performed to evaluate potential predictors of response. RESULTS: Forty-nine patients met the inclusion criteria. There was a 22.4% response rate to prednisone as defined by a 50% PSA decline. An additional 16.3% of patients had a PSA decline of < 50%. Ninety percent of patients had no documented side effects. PSA responders were more likely to have bony metastases (9/11 versus 17/38, p = 0.03) and lived longer (24.7 versus 15.4 months median survival p = 0.02). The median duration of response in the PSA responders was 4.3 months (0.89-30). Of all PSA responders, 27% had a time to progression greater than 1 year and 45% did not require chemotherapy for the duration of the study. CONCLUSION: Prednisone monotherapy is well tolerated and is associated with a clinically relevant response rate in patients with asymptomatic HRPC. Prolonged time to progression and thus avoidance of more toxic chemotherapy is possible in some patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".