Adjuvante Therapie des Mammakarzinoms 2004
Bibliographic record
Abstract
The emerging evidence gained from randomized controlled trials accelerated the widespread use of adjuvant endocrine and cytotoxic regimens and their combinations for most breast cancer patients. Even for the earliest cancer stages with low-risk tumour profiles, endocrine treatment can be recommended as adjuvant therapy if the tumour is endocrine responsive. The 8th consensus conference on early breast cancer in St. Gallen in 2003 opened a plethora of treatment options to nearly all breast cancer patients. Key issues were the introduction of adjuvant therapy with anastrozole for those postmenopausal patients with contra-indications or intolerability of tamoxifen and the definition of a group of 'more potent' regimens like the FEC- and the taxane-based regimens for high-risk patients. Unfortunately the expert panel did not clearly define any recommendations either for choosing optimal candidates for purely endocrine treatments (which are a valid option for all patients with optimal endocrine responsive disease or arguments against chemotherapy) or for the proper high-risk patients scheduled for more aggressive regimens. In the meantime, new or updated studies have provided additional information helpful for the shared decision-making with our patients. The Canadian MA.17 study revealed a significant benefit from adding a sequential therapy with letrozole after 5 years of tamoxifen compared to tamoxifen alone. Together with the updated evaluation from the ATAC trial and the Italian ITA study, the role of adjuvant treatment with aromatase inhibitors is steadily strengthened. Several studies comparing taxane-based and taxane-free regimens showed significant survival and/or recurrence benefits for the former. These data should be communicated to the patients. In the complex process of decision-making, a profound knowledge of the study results and the early and complete involvement of the woman and her personal beliefs are mandatory.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
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".