Does frailty affect response to chemotherapy in older men with metastatic castration-resistant prostate cancer?
Bibliographic record
Abstract
e20528 Background: There is increasing recognition that frailty, which is common in older adults with cancer, may negatively impact treatment and survival. Few data exist, however, in specific disease settings. We examined the impact of frailty on elder-relevant outcomes in men with metastatic castration-resistant prostate cancer (mCRPC). Methods: Men aged 65+ with mCRPC starting first-line chemotherapy with docetaxel and prednisone were enrolled in an observational study. Frailty was evaluated with the Vulnerable Elders Survey (VES-13) questionnaire. Three main elder-relevant outcomes were assessed: physical function (timed up and go (TUG) test, timed chair stands, and grip strength), functional status (OARS-IADL), and quality of life (QOL, with the FACT-P and FACT-G for prostate-specific and general QOL, respectively). Assessments were completed before each cycle of chemotherapy. Pre-post within-group comparisons were done using student’s T-tests and linear regression, stratified by frailty status. Results: 44 patients (mean age 75) receiving chemotherapy were enrolled, of whom 56% were frail by VES-13. Frail men had worse physical function, functional status, and QOL at baseline than non-frail men (all p < 0.05). From baseline to end-of-study, functional status remained stable and both general and prostate-specific QOL improved in the majority of men. TUG scores and grip strength were stable over time in the majority of men. For all of these outcomes the trajectory was similar among frail and non-frail men. Only timed chair stand performance differed by frailty status over time; non-frail men demonstrated improvement whereas frail men declined by end-of-study. Frailty status at baseline (frail/non-frail) remained stable in the vast majority of men at chemotherapy completion. Conclusions: Contrary to our hypothesis, frail older men with mCRPC had similar changes during docetaxel-based chemotherapy in most areas of physical function, functional status, and QOL compared to non-frail older men. Although chemotherapy appears to be well-tolerated in these men, confirmation in a larger dataset is required. Importantly, the VES-13 may not be a suitable frailty measure in this population.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".