ECF chemotherapy for liver metastases due to castration-resistant prostate cancer (mCRPC).
Bibliographic record
Abstract
175 Background: Although 45% of mCRPC patients (pts) achieve prostatic-specific antigen (PSA) response with docetaxel, the objective response rate (ORR) is only 12% (Tannock 2004). Liver metastatic CRPC is uncommon and associated with shorter survival (Armstrong 2010). More active treatment might benefit these pts. ECF is highly active in gastric cancer (Findlay 1994) and response was reported in 3 of 5 liver mCRPC pts (Chao 1997). ECF has been used selectively for mCRPC pts at our centre and we retrospectively reviewed our results in pts with liver metastases with the primary objective of determining its antitumor activity. Methods: Patients with mCRPC who received ECF were identified from electronic databases. ECF (epirubicin 50 mg/m2 IV day 1, cisplatin 60 mg/m2 IV day 1 and fluorouracil 200 mg/m2 IV daily as a continuous infusion) q21d was given as per Findlay et al. Patient, tumor, treatment and outcome data were extracted from medical records. Results: 14 mCRPC pts were treated with ECF 1996-2010. 7 pts had liver metastases: median age 57 years (42-76), median PSA 320 μg/L (17-494) and ECOG PS 1:2 (6:1). All 7 pts had multiple other poor prognostic features: pain (6), >2 metastatic sites (6), anemia (6), ALP >200 IU/L (6) and less than 3 years from diagnosis (6). A median 6 cycles (4-10) of ECF were administered. PSA dropped > 50% for > 4 weeks in 5 pts (71%) with a PSA drop >90% in 4 pts. The ORR was 57% (95%CI, 20-94%) with 4 PR, 1 SD and 2 PD. Response was associated with improved symptoms and hepatic function. Adverse effects were similar to previous reports. Median PFS was 5.2 months (1.3-7.8+) and median overall survival 7.4 months (3.8-31.9). Pooling ORR data with that of Chao et al suggested a higher ORR than expected with docetaxel (58% vs 12%, p=0.03 Fisher's exact test). Conclusions: ECF was highly active in this small selected group of younger men with liver mCRPC and multiple poor prognostic features, and may be of interest for further study as a therapeutic alternative to docetaxel in mCRPC pts with liver metastases when prompt tumor shrinkage is necessary. No significant financial relationships to disclose.
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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 | 0.001 | 0.001 |
| 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) | 0.003 | 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".