Should Intermittent Androgen Deprivation Be Used in Routine Clinical Practice?
Bibliographic record
Abstract
For several decades, androgen deprivation (AD) has been the mainstay for treating metastatic prostate cancer. AD can be attained by a variety of means; however, irrespective of modality and a gratifying initial high response rate, almost all patients advance to a state of androgen independence and ultimately a hormone-refractory state. Improved understanding of the biology and mechanisms of progression to androgen independence coupled with promising preclinical data have led to investigating intermittent AD (IAD) as a way of improving disease control while maintaining quality of life. Preliminary published clinical experience, mostly from uncontrolled trials, suggests the feasibility of this approach. Two ongoing cooperative-group phase III trials are evaluating the survival impact of IAD both in patients with metastatic disease and in those with prostate-specific antigen failure post-radiation therapy. There are several unanswered questions regarding this approach, and until more definitive data regarding its safety and impact on survival are available, IAD should be considered experimental. In this review, we detail the background and preclinical scientific rational for investigating IAD, and we review published clinical experience and describe the ongoing phase III clinical trials. We also discuss special considerations for using IAD outside the context of a clinical trial.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.002 |
| 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 | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.000 | 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; both teacher heads agree on what is shown here.
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".